高渗羟乙基淀粉(200/0.5)氯化钠注射液用于择期颅脑手术麻醉效果探讨  

Investigation of anesthetic effect of hypertonic salinehydroxyethyl starch(200/0.5) on patients with craniocerebral elective surgery

作　　者：吕治全[1] 柏平[1] 闫东[1] 

机构地区：[1]重庆医科大学附属永川医院,重庆402160

出　　处：《中国现代医学杂志》2015年第10期70-73,共4页China Journal of Modern Medicine

摘　　要：目的探讨高渗羟乙基淀粉(200/0.5)氯化钠注射液用于择期颅脑手术麻醉对患者血流动力学、电解质酸碱平衡及降低颅内压效果的影响。方法选取行择期胶质瘤切除手术患者120例,以随机抽样方法分为对照组(60例)和高渗组(60例);分别给予常规羟乙基淀粉和高渗羟乙基淀粉(200/0.5)静脉输注,比较两组患者不同时间点心率(HR),平均动脉压(MAP),中心静脉压(CVP),Na+、K+、Ca2+、p H及颅内压(ICP)等指标水平。结果两组患者T2、T3及T4时间点HR和CVP指标均较T0时间点明显提高,差异有统计学意义(P<0.05);两组患者T3和T4时间点MAP指标均较T0时间点显著降低,差异有统计学意义(P<0.05);而高渗组患者T4时间点HR和MAP指标水平均明显优于对照组,差异有统计学意义(P<0.05);两组患者T1、T2、T3及T4时间点Na+和K+指标水平与T0时间点比较差异有统计学意义(P<0.05);两组患者T2、T3及T4时间点ICP水平较T0时间点均显著降低,差异有统计学意义(P<0.05);高渗组患者T4时间点ICP水平显著低于对照组,差异有统计学意义(P<0.05)。结论高渗羟乙基淀粉(200/0.5)氯化钠注射液用于行颅脑外科手术治疗患者可有效稳定血流动力学,纠正电解质酸碱平衡平衡紊乱,并抑制颅内压升高。[Objective] To investigate anesthetic effects of hypertonic saline-hydroxyethyl starch （200/0.5） on hemodynamics, electrolyte and acid-base balance and intracranial pressure reduction of patients with craniocerebral elective surgery. [ Methods ] A total of 120 patients underwent elective glioma resection were chosen and randomly divided into control group （n = 60） with conventional hydroxyethyl starch and sodium and hypertonic group （n = 60） with hypertonic saline-hydroxyethyl starch （200/0.5）. The levels of heart rate （HR）, mean arterial pressure （MAP）, central venous pressure （CVP）, Na＋, K＋, Ca2＋, pH and intracranial pressure （ICP） at different time points of both group were compared. [ Results ] The levels of HR and CVP at time points of T2, T3 and T4 of both groups were significantly higher than those at time point of To （P 〈 0.05）. The levels of MAP at time points of T3 and T4 of both groups were significantly lower than those at time point of To （P 〈 0.05）. The levels of HR and MAP at time point of T4 of hypertonic group were significantly better than those of control group （P 〈 0.05）. The levels of Na＋ and K＋ at time points of T1, T2, T3, T4 of both groups were statistically significant different compared with those at time point of To （P 〈 0.05）. The levels of ICP at time points of T2, T3, T4 of both groups were significantly lower than those at time point of To （P 〈 0.05）. The levels of ICP at time point of T4 of hypertonic group were significantly lower than those of control group （P 〈 0.05）. [ Conclusions ] Hypertonic hydroxyethyl starch （200/0.5） sodium chloride injection for patients undergoing elective glioma resection can effectively stabilize hemodynamics, correct electrolyte and acid-base balance disorder and control increased intracranial pressure.

关 键 词：高渗羟乙基淀粉(200/0.5) 神经外科 血流动力学 电解质酸碱平衡 颅内压 

分 类 号：R651.1[医药卫生—外科学]