兩種麻醉方法對CPB心臟瓣膜置換術(shù)患者血漿S100β水平及其認知功能的影響
發(fā)布時間：2019-01-06 20:44
【摘要】：目的觀察并比較七氟烷靜吸復(fù)合麻醉與丙泊酚靜脈麻醉對體外循環(huán)(CPB)下心臟瓣膜置換術(shù)患者血漿S100β蛋白水平和術(shù)后認知功能的影響。方法擇期實施CPB下心臟瓣膜置換術(shù)的患者50例,隨機分為七氟烷組與丙泊酚組,各25例。常規(guī)麻醉誘導(dǎo)后,七氟烷組采用七氟烷靜吸復(fù)合麻醉,丙泊酚組采用丙泊酚靜脈麻醉。采用腦電雙頻譜指數(shù)(BIS)監(jiān)測。分別于CPB開始前(T1)、CPB結(jié)束后1 h(T2)、CPB結(jié)束后24 h(T3)、CPB結(jié)束后48 h(T4)抽取頸內(nèi)靜脈血測定血漿S100β蛋白;分別于術(shù)前、術(shù)后24 h采用簡易精神狀態(tài)檢查量表(MMSE)評估認知功能。結(jié)果所有患者維持BIS值在40~65。兩組T2時血漿S100β蛋白水平升高,T3時逐漸回落,T4時恢復(fù)基礎(chǔ)值水平,且七氟烷組T2、T3時點血漿S100β蛋白水平低于丙泊酚組(P均0.05)。兩組術(shù)后24 h MMSE評分低于術(shù)前,且七氟烷組術(shù)后24 h MMSE評分高于丙泊酚組(P均0.05)。結(jié)論七氟烷靜吸復(fù)合麻醉及丙泊酚靜脈麻醉均能滿足CPB下心臟瓣膜置換手術(shù)的需要,但七氟烷靜吸復(fù)合麻醉可降低CPB期間患者血漿S100β蛋白水平,對術(shù)后認知功能影響較小,更有利于保護腦功能。
[Abstract]:Objective to observe and compare the effects of sevoflurane combined anesthesia and propofol intravenous anesthesia on plasma S100 尾 protein level and postoperative cognitive function in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB). Methods 50 patients undergoing cardiac valve replacement under CPB were randomly divided into sevoflurane group and propofol group. After induction of routine anesthesia, sevoflurane group was anesthetized with sevoflurane and propofol group with propofol intravenous anesthesia. Bispectral index (BIS) was used to monitor EEG. The plasma S100 尾 protein was measured before the start of CPB (1 h after T1), CPB (24 h after T2), CPB) (48 h after T3), CPB (T4). The cognitive function was evaluated by (MMSE) before and 24 hours after operation. Results all patients maintained a BIS value of 40 to 65. The level of S100 尾 protein increased at T2, decreased gradually at T3, and recovered to the basic level at T4. The level of S100 尾 protein in T2 and T3 in sevoflurane group was lower than that in propofol group (P 0.05). The MMSE score at 24 hours after operation in both groups was lower than that before operation, and the MMSE score in sevoflurane group at 24 hours after operation was higher than that in propofol group (all P 0. 05). Conclusion both sevoflurane combined anesthesia and propofol intravenous anesthesia can meet the needs of cardiac valve replacement under CPB. However, sevoflurane combined anesthesia can decrease the level of plasma S100 尾 protein in patients with CPB, and has little effect on postoperative cognitive function. More conducive to the protection of brain function.
【作者單位】： 宜昌市中心人民醫(yī)院;
【分類號】：R614.2
[Abstract]:Objective to observe and compare the effects of sevoflurane combined anesthesia and propofol intravenous anesthesia on plasma S100 尾 protein level and postoperative cognitive function in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB). Methods 50 patients undergoing cardiac valve replacement under CPB were randomly divided into sevoflurane group and propofol group. After induction of routine anesthesia, sevoflurane group was anesthetized with sevoflurane and propofol group with propofol intravenous anesthesia. Bispectral index (BIS) was used to monitor EEG. The plasma S100 尾 protein was measured before the start of CPB (1 h after T1), CPB (24 h after T2), CPB) (48 h after T3), CPB (T4). The cognitive function was evaluated by (MMSE) before and 24 hours after operation. Results all patients maintained a BIS value of 40 to 65. The level of S100 尾 protein increased at T2, decreased gradually at T3, and recovered to the basic level at T4. The level of S100 尾 protein in T2 and T3 in sevoflurane group was lower than that in propofol group (P 0.05). The MMSE score at 24 hours after operation in both groups was lower than that before operation, and the MMSE score in sevoflurane group at 24 hours after operation was higher than that in propofol group (all P 0. 05). Conclusion both sevoflurane combined anesthesia and propofol intravenous anesthesia can meet the needs of cardiac valve replacement under CPB. However, sevoflurane combined anesthesia can decrease the level of plasma S100 尾 protein in patients with CPB, and has little effect on postoperative cognitive function. More conducive to the protection of brain function.
【作者單位】： 宜昌市中心人民醫(yī)院;
【分類號】：R614.2
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相關(guān)期刊論文 前6條
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