摘要
目的 探究麻醉维持应用丙泊酚联合舒芬太尼与七氟烷对颅脑损伤手术患者的影响。方法 选2018年7月至2022年8月于鹤壁煤业(集团)有限责任公司总医院行颅脑损伤手术患者60例,随机分为观察、对照组,每组30例。对照组手术时接受丙泊酚联合舒芬太尼麻醉维持,观察组接受丙泊酚联合舒芬太尼与七氟烷。分析比较两组患者不同时点临床指标[心率、平均动脉压、平均血流速度(V_(mean))、平均颈动脉血流量(Q_(mean))]、麻醉效果(呼吸恢复时间、开眼时间、拔管时间)、神经功能指标[Tau蛋白、神经元特异性烯醇化酶(NSE)、胶质纤维酸性蛋白(GFAP)]、不良反应(术中体动、嗜睡、认知障碍)。结果 T_(0)、T_(1)时刻,两组心率、平均动脉压比较差异无统计学意义(P>0.05),T_(0)时刻两组V_(mean)、Q_(mean)比较差异无统计学意义(P>0.05),T_(1)时刻,两组V_(mean)、Q_(mean)均有所降低,但观察组下降更少,差异均有统计学意义(P<0.05)。观察组呼吸恢复时间、开眼时间、拔管时间短于对照组,差异有统计学意(P<0.05)。两组术前神经功能指标比较,差异无统计学意义(P>0.05),术后3 d,两组神经功能均受到一定影响,且观察组Tua蛋白水平高于对照组,NSE、GFAP水平低于对照组,差异有统计学意义(P<0.05)。两组各有2例出现不良反应,不良反应发生率均为6.67%。结论 丙泊酚联合舒芬太尼与七氟烷在颅脑损伤手术中麻醉维持效果更好,对机体神经功能损害小,且无明显不良反应,值得临床推广。
Objective To explore the effect of propofol combined with sufentanil and sevoflurane on patients undergoing craniocerebral injury surgery during anesthesia maintenance.Methods A total of 60 patients who underwent craniocerebral injury surgery in General Hospital of Hebi Coal Industry(Group)Co.,Ltd.from July 2018 to August 2022 were randomly divided into observation group and control group,with 30 cases in each group.The control group was given propofol combined with sufentanil to maintain anesthesia during operation,and the observation group was given propofol combined with sufentanil and sevoflurane.The clinical indexes[heart rate,mean arterial pressure,mean blood flow velocity(V_(mean)),mean carotid blood flow(Q_(mean))],anesthetic effect(respiratory recovery time,start time,extubation time),neurological indexes[Tau protein,neuron specific enolase(NSE),glial fibrillary acidic protein(GFAP)]and adverse reactions(intraoperative movement,drowsiness,cognitive impairment)of the two groups at different time points were analyzed and compared.Results There was no statistically significant difference in heart rate and mean arterial pressure between the two groups at T_(0) and T_(1) time(P>0.05),and there was no statistically significant difference in V mean and Q mean between the two groups at T_(0) time(P>0.05).At T_(1) time,V mean and Q mean in the two groups decreased,but the decrease in the observation group was less,and the difference was statistically significant(P<0.05).The respiratory recovery time,eye opening time and extubation time in the observation group were shorter than those in the control group(P<0.05).There was no statistically significant difference in preoperative neurological function indexes between the two groups(P>0.05).Three days after operation,the neurological functions of the two groups were affected to some extent,and the Tua protein level in the observation group was higher than that in the control group,while the NSE and GFAP level in the observation group were lower than those in the cont
作者
李安超
周锐钢
魏永川
LI Anchao;ZHOU Ruigang;WEI Yongchuan(Operating Room,General Hospital of Hebi Coal Industry(Group)Co.,Ltd.,Hebi 458000,China)
出处
《河南医学研究》
CAS
2023年第9期1674-1677,共4页
Henan Medical Research
关键词
颅脑损伤手术
麻醉维持
丙泊酚
舒芬太尼
七氟烷
craniocerebral injury surgery
anesthesia maintenance
propofol
sufentanil
sevoflurane
