脑瘤手术时异丙酚的脑保护作用  

Cerebral protective effect of propofol during brain tumor resection

作　　者：梁敏[1] 白令君[2] 

机构地区：[1]海口市人民医院麻醉科,570208 [2]南开大学化学系

出　　处：《中华麻醉学杂志》1998年第11期668-670,共3页Chinese Journal of Anesthesiology

摘　　要：目的:探讨脑瘤手术期间异丙酚在体内的抗氧化特性及脑保护作用。方法:择期行脑瘤手术患者20例。随机分为观察组(异丙酚组,A组,n=10)和对照组(异氟醚组,B组,n=10)。以电子自旋共振方法测定血浆OFR及用化学方法测定LPO含量。结果:两组手术前OFR、LPO显著高于正常值。开颅手术2小时后两组OFR、LPO较术前显著性升高(P<0.05),开颅手术4小时后观察OFR、LPO较术前及手术2小时后显著性降低(P<0.01),而对照组则较手术2小时后显著性升高(P<0.01)。结论:脑瘤患者术前存在OFR代谢紊乱,开颅手术可加重脑的再灌注损伤。临床麻醉剂量的异丙酚可有效地清除OFR,有显著的脑保护作用。Objective: To study the antioxide properties of propofol in vivo and its cerebral protective effect during brian tumor resection. Method: Twenty patients scheduled for undergoing brain tumor resection,were randomized to receive propofol (group A, n=10) and isoflurane (group B, n=10) as control. Electron spin resonance spectroscopy method was used to measure plasma oxygen free radicals (OFR) and thiobarbitaI method to measure the plasma lipid peroxide (LPO) level. Result:The OFR and LPO levels were significantly higher in all patients than normal values before operation(P<0.05). In both groups the OFR and LPO levels were significantly increased after two hours of neurosurgery compared with those before operation(P<0.01). In group A,the two values reduced markadly four hours following neurosurgery compared with those before operation and two hours following neurosurgery (P<0.01), but in group B were more than those two hours following neurosurgery (P<0.01), with significant differences between both groups (P<0.01). Conclusion:There is OFR metabolism disorder in patients with brain tumor before operation. Surgical procedures on the brain may induce secondary cerebral ischemia causing neurologic injury. Therapeutic dose of propofol may play a role in brain protection and act as an OFR scavenger in vivo. Intravenous infusion of propofol during neurosurgery can abate the secondary cerebral injury.

关 键 词：脑肿瘤 氧自由基 过氧化脂质 二异丙酚 外科手术 

分 类 号：R739.410.5[医药卫生—肿瘤] R971.2[医药卫生—临床医学]