依达拉奉对严重烧伤手术患者多脏器的保护作用  

A study on multiple organ protection of edaravone in operation of the patients burned severely

作　　者：解温品 徐丽[2] 秦士新[2] 董肇杨[3] 史亮[1] 朱凯敏 丁雪娇[1] 姜雪飞[1] 陈丽[1] 刁宏山 刘祖德[4] 

机构地区：[1]武警上海总队医院麻醉科,201103 [2]武警上海总队医院院部,201103 [3]武警上海总队医院烧伤科,201103 [4]武警总医院药剂科,北京100039

出　　处：《武警医学》2013年第11期925-928,共4页Medical Journal of the Chinese People's Armed Police Force

基　　金：上海市卫生局立项课题(2010166)

摘　　要：目的研究依达拉奉（edaravone）对严重烧伤手术患者多脏器保护的安全性和有效性。方法严重烧伤手术患者60例，ASAⅡ～III级，随机分为依达拉奉组（E组）和生理盐水对照组（C组），每组30例。采用静吸复合全身麻醉。E组患者在麻醉诱导完成后静脉泵人依达拉奉60mg，C组泵人生理盐水40ml；先以40ml／h速度泵入30min，然后以10ml／h速度泵入其余药量。监测记录患者生命体征，并于麻醉前（T1）、手术1h（T2）、术毕（T3）、术后24h（T4）4个时点抽取静脉血，检测各时点的肝肾功能、III清SOD、MDA、S-100b、NSE、cTnI、BNP等指标。结果在术毕及术后24h时点，E组患者的cTnI较基础值、C组均显著降低（P〈0．01），C组患者较基础值显著升高（P〈0．01）；在术后1h及术毕时点，E组患者的MDA较基础值、C组均显著降低（P〈0．叭），C组患者较基础值显著升高（P〈0．01）；在术后1h及术毕时点，E组患者的SOD较基础值明显升高（P〈0．05）、较C组均显著升高（P〈0．01），两组患者在术后24h均较基础值显著降低（P〈0．01）；两组患者BNP、NSE各时点比较差异无统计学意义（P〉0．05）；两组患者肝肾功能比较差异无统计学意义（P〉0．05）。结论依达拉奉持续输注用于严重烧伤患者手术，可有效降低心肌损伤和氧自由基损伤，可抑制心力衰竭和脑损伤，不影响肝肾功能，且无不良反应，是一种安全可靠、效果确切的脏器保护药物。Objective To study the effect of edaravone on multiple organ protection in operation of the patients burned severely. Methods Sixty patients burned severely, ASA grade II - III, were randomly divided into edaravone group （group E） and saline control group （group C）. 30 cases in each group. General anesthesia was used. Patients in group E were injected with 60mg （40ml） of edara- vone, and patients in group C with saline 40ml. At the first 30min, 40ml/h speed infusion, and then 10 ml/h. Patient＇ s vital signs were onitored. The functions of liver and kidneys and the serum concentrations of SOD, MDA, S - 100b, NSE, cTnI, BNP were erected at this times ： before anesthesia （ T1 ）, lh after operation （T2 ）, the end of operation （T3 ）, 24h after operation （T4 ）. Results At T3 and T,, compared with the basic value and group C, cTnI of patients in group E significantly decreased （P 〈0.01 ） ; compared with the basic val- ue, cTnI of patients in group C increased significantly （ P 〈 0.01 ）. At T2 and T3 , compared with the basic value, MDA of patients in group E was significantly reduced（P 〈0.01 ）, but increased significantly in the group C（P 〈 0.01 ）. At T2 and T3, compared with the basic value, SOD of patients in group E was increased significantly （ P 〈 0.05 ） ; and compared with group C, it was increased significantly （P 〈0.01 ）. There were no significant differences between the two groups in BNP, NSE at different time points （P 〉0.05）. There was no significant difference between the two groups in liver and kidney functions （P 〉 0.05 ）. Conehlsions In the operation of patients se- verely bumed, edaravone effectively reduces the myocardial injury and the injury of oxygen free radicals, inhibits heart failure and brain damage, does not affect the function of liver and kidney, and has no adverse reactions. It is a safe and reliable protective drug.

关 键 词：烧伤 脏器保护 自由基 依达拉奉 

分 类 号：R614.24[医药卫生—麻醉学]