摘要
目的探讨程序化镇静镇痛联合适度过度通气对重症颅脑损伤术后患者脑氧代谢指标及神经细胞因子水平的影响。方法选取2020年1月至2022年1月我院收治的70例重症颅脑损伤手术患者,以数字表法将其分为对照组和观察组,各35例。对照组术后接受适度过度通气治疗,观察组在对照组基础上联合程序化镇静镇痛治疗。比较两组的治疗效果。结果治疗后,观察组Ramsay镇静评分(RSS)评分高于对照组,疼痛数字评分法(NRS)评分低于对照组(P<0.05)。治疗后,观察组的颈内静脉血氧饱和度(SjO_(2))及神经元特异性烯醇化酶(NSE)、S100β蛋白、β-内啡肽(β-EP)水平低于对照组,脑氧摄取率(CEO_(2))、脑动静脉血氧含量差(AVDO_(2))均高于对照组(P<0.05)。观察组的重症监护病房(ICU)治疗时间、住院时间短于对照组,谵妄发生率、30 d内病死率低于对照组(P<0.05)。结论程序化镇静镇痛联合适度过度通气治疗重症颅脑损伤术后患者的效果显著,有助于缓解患者疼痛,减轻脑耗氧,有效改善神经细胞因子水平,促进恢复,改善预后。
Objective To investigate the effects of programmed sedation and analgesia combined with moderate hyperventilation on cerebral oxygen metabolism indexes and nerve cell factors levels in patients with severe craniocerebral injury after surgery.Methods A total of 70 surgery patients with severe craniocerebral injury admitted in our hospital from January 2020 to January 2022 were divided into control group and observation group by number table method,with 35 cases in each group.The control group was treated with moderate hyperventilation after surgery,and the observation group was treated with programmed sedation and analgesia on the basis of the control group.The therapeutic effects of the two groups were compared.Results After treatment,the Ramsay Sedation Scale(RSS)score of the observation group was higher than that of the control group,and the Numerical Rating Scale(NRS)score was lower than that of the control group(P<0.05).After treatment,the jugular bulb oxyhemoglobin saturation(SjO_(2)),neuron-specific enolase(NSE),S100βprotein andβ-endorphine(β-EP)levels in the observation group were lower than those in the control group,and the cerebral extraction of oxygen(CEO_(2))and cerebral arteiovenous oxygen differenee(AVDO_(2))were higher than those in the control group(P<0.05).The intensive care unit(ICU)treatment time and hospitalization time of the observation group were shorter than those of the control group,and the incidence of delirium and mortality within 30 d were lower than those of the control group(P<0.05).Conclusion Programmed sedation and analgesia combined with moderate hyperventilation in the treatment of patients with severe craniocerebral injury after surgery has a significant effect,which is helpful to relieve pain,reduce cerebral oxygen consumption,effectively improve nerve cell factors levels,promote recovery and improve prognosis.
作者
王琴
吴文斌
WANG Qin;WU Wenbin(People's Hospital of Tongchuan,Tongchuan 727000,China)
出处
《临床医学研究与实践》
2023年第20期53-56,共4页
Clinical Research and Practice
关键词
程序化镇静镇痛
适度过度通气
重症颅脑损伤
programmed sedation and analgesia
moderate hyperventilation
severe craniocerebral injury
