术中应用携氧液对高血压脑出血患者血清髓鞘碱性蛋白的影响(英文)  

Impact of the application of oxygenised liquid during the surgery on serous myelin basic protein in the patients with hypertensive cerebral haemorrhage

作　　者：王宁[1] 刘宏毅[2] 邹元杰[2] 

机构地区：[1]南京医科大学附属脑科医院麻醉科,江苏省南京市210029 [2]南京医科大学附属脑科医院神经外科,江苏省南京市210029

出　　处：《中国临床康复》2004年第25期5454-5455,共2页Chinese Journal of Clinical Rehabilitation

基　　金：Science and Technology Foundation of Health Bureau of Jiangsu Province, No.S9701

摘　　要：背景:在高血压脑出血的治疗中,目前临床上应用多种方式改善机体缺氧,术中应用携氧液是否对高血压脑出血患者神经细胞有保护作用?目的:研究高血压脑出血术中应用携氧液对患者神经元特异性烯醇化酶的影响及脑保护作用。设计:随机对照的实验研究。地点和对象:研究地点为南京医科大学脑科医院临床麻醉研究室,对象为1999/2001年南京脑科医院收治的高血压脑出血手术患者。选择头颅CT示出血量40～60mL,美国麻醉协会(ASA)分级为I～III级,其中男26例,女14例,平均62岁。随机分为携氧液组和对照组。方法:两组术中分别采用输注携氧液和平衡液。主要观察指标:分别观察两组患者术前和术后12h的血清髓鞘碱性蛋白的浓度,术前和术后第7天的格拉斯格评分以及手术各阶段的颅内压力。结果:两组颅内压在手术前和诱导后无差别,在清除血肿至术毕,携氧液组颅内压犤(1.87±0.24,1.73±0.18)kPa犦明显低于对照组犤(2.10±0.38,1.92±0.22)kPa犦犤(t=2.37,P<0.05;t=3.06,P<0.01)犦;术后12h,携氧液组血清髓鞘碱性蛋白犤(4.1±1.35)μg/L犦明显低于对照组犤(5.2±1.42)μg/L犦(t=2.58,P<0.05)。术后第7天,携氧液组格拉斯哥评分(13.6±0.88)明显高于对照组(12.7±1.22)(t=2.74,P<0.05)。BACKGROUND:In the treatment of hypertensive cerebral haemorrhage, many approaches are clinically applied to improve hypoxia at present.Whether the application of oxygenised liquid during surgery had protective effects on neurocyte in the patients with hypertensive cerebral haemorrhage?OBJECTIVE:To investigate the impact and brain protective effect of the application of oxygenised liquid during the surgery of hypertensive cerebral haemorrhage on the myelm basic protein(MBP). DESIGN:A randomised controlled trial.SETTING and PARTICIPANTS:Study was conducted in the Department of Clinical Anaesthesia of Brain Hospital of Nanjing Medical University.Subjects were surgical patients with hypertensive cerebral haemorrhage admitted by Nanjing Brain Hospital from 1999 to 2001.The inclusive cases were cases with 40 mL to 60 mL of bleeding as shown in cranial CT and grade I-III of American Society of Anaesthesiologist(ASA) classification.INTERVENTIONS:Oxygenised liquid or equilibrium liquid was intravenously injected respectively into the patients of two groups during the surgery.MAIN OUTCOME MEASURES:Serous myelin basic protein(MBP) concentrations before and 12 hours after operation in the patients of two groups were observed respectively.The preoperative and postoperative(on the 7th day) Glasgow coma scale(GCS) as well as the intracranial pressure at each operative stage was observed. RESULTS:There was no difference of intracranial pressure before surgery and after induction between two groups. The intracranial pressures of oxygenised liquid group[(1.87±0.24) and(1.73±0.18) kPa]at haematoma removal and after operation respectively were significantly lower than[(2.10±0.381) and(1.92±0.22) kPa]of control group(t=2.37,P< 0.05;t=3.06,P< 0.01).Serous MBP at postoperative 12 hours in oxygenised liquid group was[(4.1±1.35) μg/L],which was significantly lower than[(2.2±1.42) μg/L] of control group(t=2.58,P< 0.05). The GCS at the 7th postoperative day in oxygenised liquid group was(13.6 ±0.88),which was significantly higher

关 键 词：携氧液 高血压脑出血 血清髓鞘碱性蛋白 脑保护 神经元特异性烯醇化酶 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R544.1[医药卫生—临床医学]