摘要
目的颅脑外伤多为昏迷患者,手术中麻醉对其生理应激、血流动力学及神经功能均有一定影响,选择合理的麻醉方案,有助于手术的顺利进行。丙泊酚是一种安全性较高的麻醉药物,本研究旨在探讨丙泊酚全身麻醉对颅脑外伤急诊手术患者各项指标的影响。方法选择2018-01-01-2019-01-01南阳医学高等专科学校第一附属医院收治的74例颅脑外伤急诊手术患者作为研究对象,按照组间基本特征均衡可比的原则,将采用丙泊酚全麻的37例患者作为观察组,将采用异氟烷全麻的37例患者作为对照组。比较两组神经损伤程度、氧化应激及血流动力学指标。结果手术30min时,观察组Tau蛋白(Tau protein,Tau)为(5.21±0.11)ng/L,低于对照组的(6.14±0.10)ng/L,t=38.053,P<0.001;胶质纤维酸性蛋白(glial fibril-lary acidic portein,GFAP)为(0.20±0.04)ng/L,低于对照组的(0.32±0.03)ng/L,t=14.599,P<0.001;神经元特异性烯醇化酶(neuron-specific enolase,NSE)为(40.15±1.13)μg/L,低于对照组的(47.71±1.20)μg/L,t=27.899,P<0.001。术毕时,观察组Tau为(3.79±0.12)ng/L,低于对照组的(4.68±0.15)ng/L,t=28.182,P<0.001;观察组GFAP为(0.14±0.02)ng/L,低于对照组的(0.25±0.04)ng/L,t=14.962,P<0.001;观察组NSE为(27.84±1.09)μg/L,低于对照组的(36.73±1.18)μg/L,t=33.663,P<0.001。手术30min时,观察组丙二醛(malondialdehyde,MDA)为(8.35±0.92)μmol/L,低于对照组的(10.21±1.14)μmol/L,t=7.723,P<0.001;超氧化物歧化酶(super-oxide dismutase,SOD)为(88.47±7.51)U/L,高于对照组的(70.25±7.52)U/L,t=10.428,P<0.001;血红素加氧酶-1(heme oxygenase-1,HO-1)为(69.48±2.15)U/L,高于对照组的(58.52±2.03)U/L,t=22.546,P<0.001。术毕时,MDA为(4.92±0.69)μmol/L,低于对照组的(7.85±0.74)μmol/L,t=17.615,P<0.001;SOD为(109.42±7.26)U/L,高于对照组的(79.26±7.18)U/L,t=17.967,P<0.001;HO-1为(90.15±2.12)U/L,高于对照组的(73.83±2.06)U/L,t=33.583,P<0.001。手术30min时,观察组心率(heart rate,HR)为(78.15±4.23)�
OBJECTIVE The patients with craniocerebral trauma are mostly comatose.Anesthesia during operation has certain influence on their physiological stress,hemodynamics and nerve function.Choosing a reasonable anesthesia plan is helpful to the smooth operation.Propofol is a safe anesthetic.The purpose of this study is to explore the effect of general anesthesia with propofol on the indexes of patients with craniocerebral trauma undergoing emergency surgery.METHODS From January 1,2018 to January 1,2019,a total of 74 patients with emergency craniocerebral trauma admitted to First Affiliated Hospital of Nanyang Medical College were selected as the study objects.According to the principle of balanced and comparable basic characteristics between groups,37 patients with propofol general anesthesia were taken as the observation group and 37 patients with isoflurane general anesthesia as the control group.The degree of nerve injury,oxidative stress and hemodynamic indexes were compared between the two groups.RESULTS At 30 minutes of operation,tau protein(tau)in the observation group was(5.21±0.11)ng/L,lower than that in the control group(6.14±0.10)ng/L,t=38.053,P<0.001;GFAP was(0.20±0.04)ng/L,lower than the control group(0.32±0.03)ng/L,t=14.599,P<0.001;NSE was(40.15±1.13)μg/L,lower than the control group(47.71±1.20)μg/L,t=27.899,P<0.001.At the end of operation,Tau was(3.79±0.12)ng/L,lower than the control group(4.68±0.15)ng/L,t=28.182,P<0.001;GFAP was(0.14±0.02)ng/L,lower than the control group(0.25±0.04)ng/L,t=14.962,P<0.001;NSE was(27.84±1.09)μg/L,lower than the control group(36.73±1.18)μg/L,t=33.663,P<0.001.At30 minutes of operation,malondialdehyde(MDA)in the observation group was(8.35±0.92)μmol/L,lower than that in the control group(10.21±1.14)μmol/L,t=7.723,P<0.001;super oxide dismutase(SOD)was(88.47±7.51)U/L,higher than that in the control group(70.25±7.52)U/L,t=10.428,P<0.001;heme oxygenase-1(HO-1)was(69.48±2.15)U/L,higher than that of the control group(58.52±2.03)U/L,t=22.546,P<0.001.At the end
作者
汪金娇
李海中
刘彦锋
WANG Jin-jiao;LI Hai-zhong;LIU Yan-feng(Department of Anesthesiology,First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,P.R.China)
出处
《社区医学杂志》
2020年第11期792-795,共4页
Journal Of Community Medicine
关键词
颅脑外伤
丙泊酚
神经损伤
氧化应激
血流动力学
craniocerebral trauma
propofol
general anesthesia
nerve damage
oxidative stress