摘要
目的探讨异丙酚联合瑞芬太尼对急性颅脑外伤手术患者脑细胞的保护作用。方法选取2016年1月至2017年3月在医院行手术治疗的急性颅脑外伤患者89例,按随机对照、双盲法分为对照组(44例,采用异氟醚联合瑞芬太尼维持麻醉)和研究组(45例,采用异丙酚联合瑞芬太尼维持麻醉)。结果研究组患者术中1 h、术后1 h血清神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)、D-二聚体(D-D)、S-100β蛋白、超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)水平均明显低于对照组患者(P<0.05);两组患者麻醉前、术中1 h、术后1 h的肿瘤坏死因子α(TNF-α)水平比较无明显差异(P>0.05);两组术后不良反应发生率相当(18.33%比13.33%,P>0.05)。结论采取异丙酚联合瑞芬太尼麻醉方案,可减轻急性颅脑外伤手术患者的炎性反应,具有保护脑细胞的作用。
Objective To investigate the protective effect of propofol combined with remifentanil on brain cells in patients with acute craniocerebral trauma.Methods Totally 89 patients with acute craniocerebral trauma undergoing operation in our hospital from January 2016 to March 2017 were selected and divided into the control group（ n = 44,treated with isoflurane combined remifentanil for maintenance anesthesia） and the study group（ n = 45,treated with propofol combined remifentanil for maintenance anesthesia） by randomized,controlled,double blind method.Results The levels of serum neuron specific enolase（ NSE） and myelin basic protein（ MBP）,D-dimer（ D-D）,S100β protein,high sensitivity C reactive protein（ hs-CRP） and interleukin-6（ IL-6） in the study group were significantly lower than those in the control group at intraoperative 1 h and postoperative 1 h,respectively.There was no significant difference in the levels of tumor necrosis factor-α（ TNF-α） between the two groups before anesthesia,intraoperative 1 h and postoperative 1 h（ P〉0.05）.There was no significant difference in the incidence rate of adverse reactions between the two groups（ 18.33% vs.13.33%,P〉0.05）.Conclusion Propofol combined with remifentanil can relieve the inflammatory reaction in the patients with acute craniocerebral trauma,and it can protect the brain cells.
作者
周海洲
黄倩洁
邓利兵
杨传信
鲍方
蒋晖
Zhou Haizhou,Huang Qianjie,Deng Libing,Yang Chuanxin,Bao Fang,Jiang Hui(Department of Anesthesiology,Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University of Shanghai,Shanghai,China 20000)
出处
《中国药业》
CAS
2018年第16期43-45,共3页
China Pharmaceuticals
基金
上海市卫生局卫生政策课题[2014HP020]
关键词
异丙酚
瑞芬太尼
急性颅脑外伤
脑细胞
临床疗效
propofol
remifentanil
acute craniocerebral trauma
brain cells
clinical effect
