摘要
目的探讨丙泊酚静脉麻醉对急性重型颅脑损伤手术患者的脑保护作用。方法选择急性重型颅脑损伤手术患者70例，按入院顺序随机分成对照组与观察组，每组35例。观察组静脉给予丙泊酚2mg／kg进行麻醉诱导，然后以4mg·kg^-1·h^-1维持；对照组给予咪达唑仑0．06mg／kg进行麻醉诱导，然后间断吸入异氟烷维持。两组患者静脉麻醉诱导均加用丙泊酚1．2mg／kg，芬太尼4μg／kg，维库溴铵0．15mg／kg。记录麻醉前、术中和术后3h患者颅内压和脑氧分压的变化情况，且记录患者术后初醒时间。结果两组术后3h与麻醉前比较颅内压明显下降，脑氧分压明显升高；且观察组的颅内压明显低于对照组[（18．98±3．98）mmHg与（21．76±4．01）mmHg]（t=7．20，P〈0．05），脑氧分压明显高于对照组[（17．09±3．03）mmHg与（14．67±2．63）mmHg]（t=7．23，P〈0．05），观察组的初醒时间短于对照组[（15．98±2．01）h与（20．01±1．23）h]（t=7．96，P〈0．05）。结论丙泊酚静脉麻醉对急性重型颅脑损伤手术患者具有良好的脑保护作用，值得临床推广应用。
Objective To study the cerebral protective effect of intravenous propofol anaesthesia on the pa- tients with avute severe brain injury. Methods 70 patients with acute severe brain injury were randomly divided into control group and observation group, each group had 35 cases. The observation group was given intravenously propofol 2mg/kg for anesthesia induction, then maintaining anesthetization by 4mg·kg^-1·h^-1. The control group was given midazolam,then discontinuous indrawed isoflurane. Diprivan 1.2mg,/kg, fentanyl 4μg/kg and veeuronium bromide 0. 15mg/kg were also used intravenously for the maintenance of anesthesia. The changes of intracranial pressure（IP） and cerebral oxygen partial pressure （COP） before anesthetization, surgery, 3 hours after surgery and the waking time of surgery were recorded. Results After treatment, IP of two groups was decreased and COP was increased sharply; the IP of observation group was（ 18.98±3.98） mm Hg, which was lower than （ 21.76±4.01 ） mm Hg of the control group （ t = 7.20,P 〈 0.05 ）, COP was （ 17.09± 3.03 ）mm Hg, which was higher than （ 14.67±2.63 ） mm Hg of the control group（t = 7.23 ,P 〈 0.05）. The wake time of observation group was （ 15.98 ±2.01 ） h, which was shorter than （20.01±1.23）h of the control group（t =7.96,P 〈0.05）. Conclusion The cerebral protective effect of intravenous propofol anaesthesia is good in patients with acute severe brain injury;it is worth to popularize in clinic.
出处
《中国基层医药》
CAS
2013年第14期2119-2121,共3页
Chinese Journal of Primary Medicine and Pharmacy
关键词
丙泊酚
颅脑损伤
脑
细胞保护
Propofol
Craniocerebral trauma
Brain
Cytoprotection
