摘要
目的:探讨七氟烷对大面积烧伤患者心肌保护作用及炎症因子的影响。方法:选择2019年4月-2020年10月于南昌大学第一附属医院择期行切痂术大面积烧伤患者100例,随机分为S组和P组,各50例。S组予以七氟烷联合瑞芬太尼麻醉,P组予以丙泊酚联合瑞芬太尼麻醉。比较两组切痂前5 min(T_(0))、切痂后5 min(T_(1))、切痂后25 min(T_(2))、切痂后45 min(T_(3))的血流动力学指标[心率(HR)、脉氧饱和度(SpO_(2))、中心静脉压(CVP)和平均动脉压(MAP)]及麻醉诱导前、术毕时、术毕24 h的炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和核转录因子-κB(NF-κB)]和心肌损伤标记物[心肌肌钙蛋白Ⅰ(cTnⅠ)、肌酸激酶同工酶(CK-MB)]。结果:T_(0)、T_(1)、T_(2)、T_(3)时,两组各项血流动力学指标比较,差异均无统计学意义(P>0.05);两组术毕时、术毕24 h的IL-6、TNF-α和NF-κB均高于麻醉诱导前,S组术毕时、术毕24 h的IL-6、TNF-α和NF-κB均低于P组(P<0.05);两组麻醉诱导前cTnⅠ和CK-MB比较,差异均无统计学意义(P>0.05);两组术毕时、术毕24 h的cTnⅠ和CK-MB均低于麻醉诱导前,S组术毕时、术毕24 h的cTnⅠ和CK-MB均低于P组(P<0.05)。结论:在切痂术中,七氟烷与丙泊酚麻醉均可维持大面积烧伤患者血流动力学稳定,但七氟烷可更有效地降低炎症因子水平,减少心肌细胞损伤。
Objective:To investigate the Protective effect of Sevoflurane on myocardium and its influence on inflammatory factors in patients with extensive burn.Method:A total of 100 cases of extensive burn patients who underwent elective eschar excision in the the First Affiliated Hospital of Nanchang University from April 2019to October 2020 were selected and randomly divided into group S and group P,50 cases in each group.group S was anesthetized with Sevoflurane combined with Remifentanil,and group P was anesthetized with Propofol combined with Remifentanil.The hemodynamic indexes[heart rate(HR),pulse oxygen saturation(SpO_(2)),central venous pressure(CVP)and mean arterial pressure(MAP)]of 5 min before eschars removal(T_(0)),5 min after eschars removal(T_(1)),25 min after eschars removal(T_(2)),and 45 min after eschars removal(T_(3))were compared between the two groups.And the inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and nuclear transcription factor-κB(NF-κB)]and myocardial injury markers[cardiac troponinⅠ(cTnⅠ),creatine kinase isoenzymes(CK-MB)]before anesthesia induction,at the end of surgery,6,24 h after surgery were compared between the two groups.Result:At T_(0),T_(1),T_(2)and T_(3),there were no significant differences in various hemodynamic indexes between the two groups(P>0.05).The levels of IL-6,TNF-αand NF-κB at the end of surgery,24 h after surgery in the two groups were higher than those before anesthesia induction,and the levels of IL-6,TNF-αand NF-κB at the end of surgery,24 h after surgery in the group S were lower than those in the group P(P<0.05).There were no significant differences in cTnⅠand CK-MB levels between the two groups before anesthesia induction(P>0.05).The cTnⅠand CK-MB levels at the end of surgery,24 h after surgery in the two groups were lower than those before anesthesia induction,and the cTnⅠand CK-MB levels at the end of surgery,24 h after surgery in the group S were lower than those in the group P(P<0.05).Conclusion:Both Sevoflurane and
作者
陈美玲
张璐璐
胡春华
CHEN Meiling;ZHANG Lulu;HU Chunhua(The First Affiliated Hospital of Nanchang University,Nanchang 330006,China;不详)
出处
《中国医学创新》
CAS
2023年第1期23-27,共5页
Medical Innovation of China
基金
江西省卫生计生委科技计划项目(20191031)。
关键词
七氟烷
丙泊酚
烧伤
心肌
Sevoflurane
Propofol
Burn
Myocardial
