目的：探讨不同全身麻醉方法对缺血性脑血管疾病神经介入手术患者术后认知功能的影响.方法：选择择期在全麻下行神经介入手术的缺血性脑血管疾病患者80例,年龄≥60岁,美国麻醉医师协会（ASA）Ⅰ~Ⅲ级,随机分为丙泊酚组（P组,丙泊酚复合...目的：探讨不同全身麻醉方法对缺血性脑血管疾病神经介入手术患者术后认知功能的影响.方法：选择择期在全麻下行神经介入手术的缺血性脑血管疾病患者80例,年龄≥60岁,美国麻醉医师协会（ASA）Ⅰ~Ⅲ级,随机分为丙泊酚组（P组,丙泊酚复合瑞芬太尼）和七氟烷组（S组,七氟醚复合瑞芬太尼）各40例.围术期采用FORE-SIGHT脑氧饱和度监测仪持续监测患者的脑氧饱和度（SctO2）,分别于术前1d、术后6h、术后24h采用简易智能状态检查量表（Mini-Mental State Exam,MMSE）评价患者的认知功能,并采血检测炎症因子（TNF-α、IL-1β、IL-6）的变化.记录患者术中血管活性药物使用量、术中体动以及苏醒期情况.结果：S组患者苏醒情况优于P组,围术期血管活性药物使用量更少,SctO2下降的相对值更小,术后6h认知功能障碍的发生率更低;两组患者不同时间点炎症因子的表达以及术中体动、苏醒期躁动情况差异无统计学意义.结论：神经介入手术患者采用七氟烷维持麻醉,围术期能更好的维持脑氧饱和度,术后清醒更快,术后早期认知功能障碍的发生率更低.展开更多
Although hyperbaric oxygen （HBO） therapy can promote the recovery of neural function in patients who have suffered traumatic brain injury （TBI）, the underlying mechanism is unclear. We hypothesized that hyperbaric...Although hyperbaric oxygen （HBO） therapy can promote the recovery of neural function in patients who have suffered traumatic brain injury （TBI）, the underlying mechanism is unclear. We hypothesized that hyperbaric oxygen treatment plays a neuroprotective role in TBI by increasing regional transcranial oxygen saturation （rSO2） and oxygen partial pressure （PaO2）. To test this idea, we compared two groups： a control group with 20 healthy people and a treatment group with 40 TBI patients. The 40 patients were given 100% oxygen of HBO for 90 minutes. Changes in rSO2 were measured. The controls were also examined for rSO2 and PaO2, but received no treatment, rSO2 levels in the patients did not differ significantly after treatment, but levels before and after treatment were significantly lower than those in the control group. PaO2 levels were significantly decreased after the 30-minute HBO treatment. Our findings suggest that there is a disorder of oxygen metabolism in patients with sub-acute TBI. HBO does not immediately affect cerebral oxygen metabolism, and the underlying mechanism still needs to be studied in depth.展开更多
文摘目的：探讨不同全身麻醉方法对缺血性脑血管疾病神经介入手术患者术后认知功能的影响.方法：选择择期在全麻下行神经介入手术的缺血性脑血管疾病患者80例,年龄≥60岁,美国麻醉医师协会（ASA）Ⅰ~Ⅲ级,随机分为丙泊酚组（P组,丙泊酚复合瑞芬太尼）和七氟烷组（S组,七氟醚复合瑞芬太尼）各40例.围术期采用FORE-SIGHT脑氧饱和度监测仪持续监测患者的脑氧饱和度（SctO2）,分别于术前1d、术后6h、术后24h采用简易智能状态检查量表（Mini-Mental State Exam,MMSE）评价患者的认知功能,并采血检测炎症因子（TNF-α、IL-1β、IL-6）的变化.记录患者术中血管活性药物使用量、术中体动以及苏醒期情况.结果：S组患者苏醒情况优于P组,围术期血管活性药物使用量更少,SctO2下降的相对值更小,术后6h认知功能障碍的发生率更低;两组患者不同时间点炎症因子的表达以及术中体动、苏醒期躁动情况差异无统计学意义.结论：神经介入手术患者采用七氟烷维持麻醉,围术期能更好的维持脑氧饱和度,术后清醒更快,术后早期认知功能障碍的发生率更低.
基金supported by a grant from Suzhou Key Medicine Project Fund of China,No.Szxk201504
文摘Although hyperbaric oxygen （HBO） therapy can promote the recovery of neural function in patients who have suffered traumatic brain injury （TBI）, the underlying mechanism is unclear. We hypothesized that hyperbaric oxygen treatment plays a neuroprotective role in TBI by increasing regional transcranial oxygen saturation （rSO2） and oxygen partial pressure （PaO2）. To test this idea, we compared two groups： a control group with 20 healthy people and a treatment group with 40 TBI patients. The 40 patients were given 100% oxygen of HBO for 90 minutes. Changes in rSO2 were measured. The controls were also examined for rSO2 and PaO2, but received no treatment, rSO2 levels in the patients did not differ significantly after treatment, but levels before and after treatment were significantly lower than those in the control group. PaO2 levels were significantly decreased after the 30-minute HBO treatment. Our findings suggest that there is a disorder of oxygen metabolism in patients with sub-acute TBI. HBO does not immediately affect cerebral oxygen metabolism, and the underlying mechanism still needs to be studied in depth.
