瑞芬太尼对重型颅脑损伤患者脑氧代谢的影响  

Effect of remifentanil on the cerebral oxygen metabolism of patients with severe brain injury

作　　者：甘国胜[1] 周翔[1] 秦明哲[1] 李师宏[1] 胡光俊[1] 宋晓阳[1] 

机构地区：[1]广州军区武汉总医院麻醉科,武汉430070

出　　处：《中国实用神经疾病杂志》2013年第19期30-31,共2页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨瑞芬太尼对重型颅脑损伤患者脑氧代谢的影响。方法将我院收治的84例重型颅脑损伤患者随机分为瑞芬太尼组和硝普钠组各42例,麻醉控制性降压分别采用瑞芬太尼和硝普钠,比较2组患者麻醉诱导前、停止降压时、停止降压后30min MAP、HR和Da-jvO2、CERO2。结果麻醉诱导前、停止降压时、停止降压后30min 2组患者MAP均无显著性差异(P>0.05);硝普钠组HR在停止降压时和停止降压后30min均显著高于瑞芬太尼组患者(P<0.05);瑞芬太尼组患者Da-jvO2、CERO2在停止降压时和停止降压后30min均显著低于硝普钠组患者(P<0.05)。结论瑞芬太尼用于重型颅脑损伤患者麻醉术中可降低脑组织氧代谢率,增强对氧气的耐受,起到有效脑保护作用。Objective To study the influence of remifentanil for the cerebral oxygen metabolism of patients with severe craniocerebral injury. Methods Totally 84 patients with severe craniocerebral injury in our hospital were randomly divided into remifentanil group and sodium nitroprusside group with 42 cases in each group, and they were respectively treated with remifentanil and sodium nitroprusside for the controlled hypotension anesthesia, then the MAP, HR and Da-jvO2, CERO2 of two groups before the induction of anesthesia, at stopping depressurization and at 30 minutes after the depressurization were compared. Results The MAP of the two groups before the induction of anesthesia, at stopping depressurization and at 30 minutes after the depressurization had no significant differences（P〉0.05）, the HR of sodium nitroprusside group at stopping depressurization and at 30 minutes after the depressurization were both higher than those of remifentanil group（P〈0.05）, the Da-jvO2 and CERO2 of remifentanil group at stopping depressurization and at 30 minutes after the depressurization were all significantly lower than those of sodium nitroprusside group（P%0.05）. Conclusion The remifentanil can decrease the brain tissue oxygen metabolism rate and improve the enhancement of oxygen tolerance, so it plays an active role in the cerebral protection.

关 键 词：瑞芬太尼 重型颅脑损伤 脑氧代谢 

分 类 号：R651.15[医药卫生—外科学]