摘要
目的 观察2种液体预扩容对颅脑外伤患者围术期血清肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）水平的影响.方法 69例颅脑外伤患者随机分为观察组33例和对照组36例.对照组术前输注复方乳酸钠（LR） 20 mL/kg,观察组术前输注6％羟乙基淀粉（HES）10 mL/kg.观察2组患者麻醉诱导前（T0）、气管插管即刻（T1）、手术完毕时（T2）及术后1 d（T3）的生命体征及血清TNF-α和IL-6的水平变化.结果 观察组心率（HR）、平均动脉压（MAP）显著下降,以及氧分压[p（O2）]显著上升均较早于对照组（P＜0.05或P＜0.01）.2组血清TNF-α和IL-6水平从T1起均显著上升（P＜0.01）,至T3显著下降（P＜0.05或P＜0.01）;组间比较,T1～T3均差异显著（P＜0.05或P＜0.01）.结论 颅脑外伤患者术前使用6％HES进行预扩容,可有效改善患者生命体征,降低血清TNF-α和IL-6水平,减轻炎症反应,改善预后.
Objective To observe the effects of two intravascular volume expansion solutions on serum levels of tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6） in perioperative patients with craniocerebral trauma. Methods 69 patients were randomly divided into observation group （n = 33） and control group （n = 36） with injection of 10 mL/kg 6% hydroxyethyl starch （HES） and 20 mL compound sodium lactate （LR） respectively. Vital signs, serum levels of TNF-α and IL-6 were recorded before anesthesia induction （To）, at tracheal intubation, at end of surgery and 1 day after surgery. Results The decreased heart rate （HR） and mean arterial pressure （ MAP ） , increased p （ O2 ） were observed earlier in observation group than the control group （ P 〈 0.05 or P 〈 0.01 ）. Serum levels of TNF-α and IL-6 increased since T1 and decreased after T3 （P 〈 0.05, P〈0.01） （P〈0.05, P〈0.01）. Conclusion Volume expansion with 6% HES can effectively maintain the vital signs and reduce levels of TNF-α and IL-6.
出处
《实用临床医药杂志》
CAS
2014年第21期52-54,共3页
Journal of Clinical Medicine in Practice
基金
中国高校医学期刊临床专项资金(11321367)
