异氟烷和七氟烷对癫癎患者脑电图的影响  

Influences of Isoflurane and Sevoflurane on Electroencephalogram of Epileptic Patients

作　　者：吉勇[1] 王明然[1] 王保国[1] 白勤[1] 张彤[1] 

机构地区：[1]中国医学科学院首都医科大学附属北京天坛医院麻醉科,北京市100050

出　　处：《天津医药》2007年第1期24-26,共3页Tianjin Medical Journal

摘　　要：目的:对比观察呼气末不同异氟烷和七氟烷浓度对癫患者脑电图及棘波的影响。方法:40例癫需行开颅手术治疗的患者,随机分为异氟烷组和七氟烷组各20例。以1.0肺泡气最低有效浓度(MAC)的异氟烷或七氟烷维持麻醉,术中置入硬膜外电极后,调整蒸发器刻度,分别控制呼气末异氟烷或七氟烷浓度于0.7、1.0、1.3、1.5MAC,并各稳定15min后,描记脑电图。结果:癫患者1.0MAC异氟烷时棘波的频数与0.7MAC时相比无明显变化,而1.3MAC和1.5MAC时棘波的频数少于0.7MAC时(P<0.01)。1.0MAC和1.3MAC七氟烷时棘波的频数与0.7MAC时相比无明显变化,1.5MAC时棘波的频数高于0.7MAC时(P<0.05)。随着呼气末异氟烷或七氟烷浓度的升高,患者的α和β波的频数逐渐减少,而δ波的频数增多。结论:癫手术术中需行皮层脑电图监测时,将异氟烷麻醉深度维持于0.7～1.0MAC或七氟烷麻醉深度维持于0.7～1.3MAC较为适宜,以保证癫源灶准确的定位及手术切除范围。Objective： To compare the effect of isoflurane and sevoflurane with different concentrations in the end of expiration on the electroencephalogram （EEG） and spike waves in epileptic patients. Methods： Forty epileptic patients for epilepsy surgery were randomly divided into two groups, the isoflurane group （n =20） and the sevoflurane group （n =20）： Anaesthesia was maintained by 1.0 MAC of isoflurane or sevoflurane after epidural electrode was planted, vaporizer scale was calibrated and the density of isoflurane or sevoflurane in the end of expiration was controlled with 0.7,1.0,1.3,1.5 MAC respectively then persisted in fifteen minutes, at last electroencephalogram was recorded. Results： The frequencies of spike （or sharp） waves of epileptic patients were similar at 0.7 MAC and 1.0 MAC isoflurane, and lower at 1.3 MAC and 1.5 MAC isoflurane than at 0.7 MAC（P 〈 0.01）. The frequencies of spike （or sharp） waves were similar at 0.7, 1.0 and 1.3MAC sevoflurane and higher at 1.5 MAC sevoflurane than at 0.7 MAC（P 〈 0.05）. The frequencies of α and β waves decreased and δ wave increased with the increase of isoflurane and sevoflurane concentration in the end of expiration. Conclusion： The maintenance of anesthesia with 0.7-1.0 MAC isoflurane or 0.7-1.3 MAC sevoflurane is suitable for the epilepsy surgery with intraoperative EEG monitoring to receive the correct location of epileptic focus and surgery excision circumsciption.

关 键 词：神经外科手术 癫癎 氟烷 异氟醚 脑电描记术 Α节律 β节律 δ节律 Θ节律 

分 类 号：R739.41[医药卫生—肿瘤]