期刊文献+

高渗氯化钠羟乙基淀粉40注射液联合控制性降压对脑膜瘤手术影响

Effect of hypertonic sodium chloride hydroxyethyl starch 40 injection combined with blood pressure control on cerebral oxygen metabolism in patients with meningioma during surgery
下载PDF
导出
摘要 目的探讨静注高渗氯化钠羟乙基淀粉40注射液(HH40)联合控制性降压对脑膜瘤切除术患者术中脑氧代谢的影响。方法择期行脑膜瘤切除术患者40例,随机分为观察组(H组)和对照组(C组),两组均施行全麻和控制性降压;H组输注HH40 8ml/kg,30min内输完;C组输注6%羟乙基淀粉,方法同H组,监测并记录输注前即刻(T0)、输注后15(T1)、60(T2)、术毕前60min(T3)和术毕时(T4)平均动脉压(MAP)、心率(HR)、中心静脉压(CVP),采集颈静脉球部和桡动脉血测定血浆Na+、K+、pH,进行血气分析,并计算T0、T2-4时脑动脉-静脉氧含量差(Da-jvO2)、脑氧摄取率(CERO2);分别于T0-4测定红细胞压积(Hct)、血红蛋白(Hb);记录术中输血量、出血量和尿量。结果与C组比较,H组Da-jvO2和CERO2在T3-4降低(P<0.05)。结论静注HH40联合控制性降压可安全地用于脑膜瘤手术患者。 Objective To study the effect of hypertonic sodium chloride hydroxylethyl starch 40 injection(HH40) combined with blood pressure control on cerebral oxygen metabolism in meningioma patients during surgery.Methods Forty patients were randomly divided into observation group(H group) and control group(C group),20 patients in each group.Meningioma was removed in patients under general anesthesia with their blood pressure controlled.Patients in H group were infused with HH40(8ml/kg) for 30min while those in C group were infused with 6% hydroxyethyl starch(8ml/kg) for 30min.Mean arterial pressure(MAP),heart rate(HR),and central venous pressure(CVP) were recorded,respectively,before HH40 infusion(T0),15(T1) and 60(T2) after HH40 infusion,60min(T3) before completion of the surgery and at the time when the surgery was completed(T4).Blood samples were collected from radial artery and jugular vein bulb for detection of Na+,K+ and pH,analysis of blood gas,and measurement of Da-jvO2 and CERO2.Hct and Hb were detected at T0-T4.Volumes of infused blood,loss of blood and urine were recorded.Results The Da-jvO2 and CERO2 were significantly lower in H group than in C group at T3-T4.Conclusion HH40 combined with blood pressure control is safely for metabolism patients during surgery.
出处 《军医进修学院学报》 CAS 2011年第1期56-58,共3页 Academic Journal of Pla Postgraduate Medical School
关键词 降压 控制性 脑膜瘤 高渗氯化钠羟乙基淀粉40注射液 Hypotension Controlled Meningioma Hypertonic Sodium Chloride Hydroxyethyl Starch 40 Injection
  • 相关文献

参考文献11

  • 1Prough DS, Kramer GC, Uchida T, et al. Effects of hypertonic arginine on ccrebralb blood flow and intracranial pressure after traumatic brain injury combined with hemorrhagic hypotension [ J ]. Shock, 2006, 26 ( 3 ) : 290-295. 被引量:1
  • 2Brod VI, Krausz MM, Hirsh M , et al .Hemodynamic effects of combined treatment with oxygen and hypertonic saline in hemorrhagic shock [J ]. Crit Care Med, 2006, 34 ( 11 ) : 2784-2791. 被引量:1
  • 3Tseng MY, Al-Rawi PG, Pickard JD, et al. Effect of hypertonic saline on crebral blood flow in poor-grade patients with subaraehnoid hemorrhage [ J ]. Stroke, 2003, 34 (6) : 1389-1396. 被引量:1
  • 4史晓勇,王亚平,常业恬,邹定全,李李,徐军美.急性高容量血液稀释联合控制性降压对锥体内固定术患者脑氧代谢的影响[J].中华麻醉学杂志,2008,28(9):849-851. 被引量:2
  • 5Mielke LL, Entholzner EK, Kling M, et al. Preoperative acute hypervolemic hemodilution with hydynxyethystarch : an alternative to acute normovolemic hemodilution( J ]. Anesth Analg, 1997, 84( 1 ): 26-30. 被引量:1
  • 6Dehne MG, Muhling J, Sablotzki A, et al. Hydroxyethyl starch (HES) does not directly affect renal function in patients with no prior renal impairment [ J ] . Clin Anesth, 2001, 13 ( 2 ) : 103-111. 被引量:1
  • 7Nirmalan M, Willard T, Edwards DJ, et al. Effects of sustained posttraumatic shock and initial fluid resuscitation on extravascular lung water content and pulmonary vascular pressures in a porcine model of shock [ J ] . Br J Anaesth, 2003, 91 (2) : 224-232. 被引量:1
  • 8刘克玄,黄雄庆,陈秉学,黄文起,黑子清,冯霞,谭洁芳.急性超容性血液稀释应用于围术期节约用血的可行性[J].中华麻醉学杂志,2002,22(2):71-74. 被引量:84
  • 9Feldman Z, Robertson CS. Monitoring of cerebral hemodynamics with jugular bulb catheters[ J ]. Crit Care Clin, 1997, 13 ( 1 ) : 51-77. 被引量:1
  • 10刘贵明,丁学琴,王多友,张秉钧.颅脑手术中过度通气对颈内静脉球血氧饱和度、脑动静脉氧及乳酸差的影响[J].中华麻醉学杂志,2001,21(8):466-469. 被引量:12

二级参考文献5

共引文献95

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部