高渗氯化钠羟乙基淀粉40注射液联合控制性降压对脑膜瘤手术影响  

Effect of hypertonic sodium chloride hydroxyethyl starch 40 injection combined with blood pressure control on cerebral oxygen metabolism in patients with meningioma during surgery

作　　者：张义轩[1] 马传根[1] 宋冬梅[1] 李爱香[1] 刘星[1] 刁玉领[2] 

机构地区：[1]河南大学淮河医院麻醉科,开封475000 [2]河南大学淮河医院神经外科,开封475000

出　　处：《军医进修学院学报》2011年第1期56-58,共3页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的探讨静注高渗氯化钠羟乙基淀粉40注射液(HH40)联合控制性降压对脑膜瘤切除术患者术中脑氧代谢的影响。方法择期行脑膜瘤切除术患者40例,随机分为观察组(H组)和对照组(C组),两组均施行全麻和控制性降压;H组输注HH40 8ml/kg,30min内输完;C组输注6%羟乙基淀粉,方法同H组,监测并记录输注前即刻(T0)、输注后15(T1)、60(T2)、术毕前60min(T3)和术毕时(T4)平均动脉压(MAP)、心率(HR)、中心静脉压(CVP),采集颈静脉球部和桡动脉血测定血浆Na+、K+、pH,进行血气分析,并计算T0、T2-4时脑动脉-静脉氧含量差(Da-jvO2)、脑氧摄取率(CERO2);分别于T0-4测定红细胞压积(Hct)、血红蛋白(Hb);记录术中输血量、出血量和尿量。结果与C组比较,H组Da-jvO2和CERO2在T3-4降低(P<0.05)。结论静注HH40联合控制性降压可安全地用于脑膜瘤手术患者。Objective To study the effect of hypertonic sodium chloride hydroxylethyl starch 40 injection（HH40） combined with blood pressure control on cerebral oxygen metabolism in meningioma patients during surgery.Methods Forty patients were randomly divided into observation group（H group） and control group（C group）,20 patients in each group.Meningioma was removed in patients under general anesthesia with their blood pressure controlled.Patients in H group were infused with HH40（8ml/kg） for 30min while those in C group were infused with 6% hydroxyethyl starch（8ml/kg） for 30min.Mean arterial pressure（MAP）,heart rate（HR）,and central venous pressure（CVP） were recorded,respectively,before HH40 infusion（T0）,15（T1） and 60（T2） after HH40 infusion,60min（T3） before completion of the surgery and at the time when the surgery was completed（T4）.Blood samples were collected from radial artery and jugular vein bulb for detection of Na＋,K＋ and pH,analysis of blood gas,and measurement of Da-jvO2 and CERO2.Hct and Hb were detected at T0-T4.Volumes of infused blood,loss of blood and urine were recorded.Results The Da-jvO2 and CERO2 were significantly lower in H group than in C group at T3-T4.Conclusion HH40 combined with blood pressure control is safely for metabolism patients during surgery.

关 键 词：降压 控制性 脑膜瘤 高渗氯化钠羟乙基淀粉40注射液 

分 类 号：R614.1[医药卫生—麻醉学]