本文選題：異丙酚 + 依托咪酯��； 參考：《武警醫(yī)學(xué)》2016年08期

【摘要】：目的觀察異丙酚麻醉對腦外傷血腫清除術(shù)患者的腦保護作用。方法腦外傷血腫清除術(shù)患者60例,隨機均分為異丙酚組和依托咪酯組。分別于麻醉前(t0)、插管后(t1)、手術(shù)開始后1 h(t2)、手術(shù)開始后2 h(t3)記錄頸內(nèi)靜脈球氧飽和度(Sjv O2)并計算腦氧攝取率(CERO2)。分別于不同時間點:手術(shù)前(T0)、手術(shù)開始后1 h(T1)、術(shù)后1 h(T2)、術(shù)后24 h(T3)抽取頸內(nèi)靜脈血樣,檢測S100β蛋白含量。術(shù)后30 d記錄患者的格拉斯哥預(yù)后評分(glasgow outcome scale,GOS)和簡易智力狀況檢查評分(mini-mental state examination,MMSE)。結(jié)果與t0時比較,t1、t2、t3時兩組Sjv O2明顯升高(P0.05);異丙酚組t1、t2、t3時CERO2(30.9%±5.04%、30.2%±6.17%、28.7%±3.21%)降低,依托咪酯組的CERO2在t1時(24.9%±4.31%)降低(P0.05);與依托咪酯組比較,異丙酚組t1、t2、t3時Sjv O2明顯升高,CERO2降低(P0.05)。患者S100β蛋白含量在T2時異丙酚組為(1.17±0.26)μg/L,小于依托咪酯組的(1.52±0.19)μg/L(P0.05)。兩組GOS和MMSE評分沒有統(tǒng)計學(xué)差異。結(jié)論異丙酚在腦外傷血腫清除手術(shù)患者具有一定的腦保護作用。
[Abstract]:Objective to observe the protective effect of propofol anesthesia on brain injury patients undergoing hematoma clearance. Methods 60 patients with traumatic hematoma were randomly divided into propofol group and etomidate group. The oxygen saturation of jugular bulb (SjvO2) was recorded before anesthesia, 1 hour after intubation, 1 hour after operation and 2 h after operation. Blood samples of internal jugular vein were collected at different time points: before operation, 1 hour after operation, 24 hours after operation. Glasgow outcome scale (Glasgow) and mini-mental state examination (MMSE) were recorded 30 days after operation. Results compared with T0, the Sjv O 2 of the two groups was significantly higher than that of the control group (P 0.05), the CERO2O 2 of the propofol group was 30.9% 鹵5.04% 鹵5.04% 鹵3.21 at t 1, the CERO2 of the etomidate group was 24.9% 鹵4.31% at t 1 and the Sjv O 2 at t 1 t 2t 3 in the propofol group was significantly higher than that in the etomidate group, and Sjv O 2 in the propofol group was significantly higher than that in the etomidate group, and the Sjv O 2 level in the propofol group was significantly higher than that in the etomidate group at t 1 and T 2t 3, and the level of Sjv O 2 in the etomidate group was significantly higher than that in the etomidate group. The S100 尾 protein content in the propofol group was 1.17 鹵0.26 渭 g / L at T2, which was lower than that in the etomidate group (1.52 鹵0.19) 渭 g / L P / L 0.05. There was no significant difference in GOS and MMSE scores between the two groups. Conclusion propofol has a protective effect on brain injury in patients with hematoma clearance.
【作者單位】： 武警北京總隊醫(yī)院麻醉科;
【分類號】：R614

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