颅内动脉瘤介入术中应用七氟烷控制性降压对病人脑耗氧量的影响  

The Effect of Sevoflurane on Cerebral Oxygen Consumption by Controlled Hypotension in Intracranial Aneurysm Clipping Operation

作　　者：聂洪杰[1] 杨春利[1] 王樱[1] 陈奇宏[1] 

机构地区：[1]河北省涿州市医院麻醉科,河北涿州072750

出　　处：《河北医学》2017年第2期281-284,共4页Hebei Medicine

基　　金：河北省保定市科学技术研究与发展指导计划;(编号:15ZF019)

摘　　要：目的:研究使用七氟烷在颅内动脉瘤介入术中对病人进行控制性降压时病人的脑耗氧量的变化。方法:2013年4月至2015年2月确诊为颅内动脉瘤并接受介入手术治疗的病人中选择90人,在其手术中使用七氟烷降压,记录麻醉开始前、开始降压前、降压过程中、降压结束后病人的各项血流动力学指标的变化情况以及血气分析情况。结果:降压开始前、降压进行过程中、降压结束后病人的动脉和静脉的血氧分压较麻醉前有了非常明显的升高,P<0.05;各个时间段病人的心率均没有太大的变化,P>0.05;动脉与静脉血液中氧气含量的差值以及脑组织氧气的吸取率全部明显的较麻醉开始前低,P<0.05。结论:将七氟烷应用到颅内动脉瘤介入手术的控制性降压中可以有效的减少血压降低之后病人大脑中氧气的代谢量,减少术后并发症的发生。Objective： To study the effect of sevoflurane on cerebral oxygen consumption by controlled hypotension in intracranial aneurysm clipping operation. Methods： 90 patients treated by intracranial aneurysm clipping operation in our hospital from April 2015 to February 2013 were selected and sevoflurane was used for depressurization in the operation,the changes of blood flow parameters before anesthesia,before depressurization,during depressurization and after depressurization were recorded and blood gas was analyzed.Results： Before depressurization,during depressurization and after depressurization,the arterial and venous partial pressure of blood oxygen all significantly increased compared with those before anesthesia（ P〈0.05）.At each stage patient＇s heart rate didn＇t change significantly（ P〉0.05）. The difference of arterial and venous blood oxygen content and oxygen uptake rate of the neurocranium were all significantly lower than those before anesthesia（ P〈0.05）. Conclusion： The application of sevoflurane to the neurosurgery operation by controlled hypotension can effectively reduce blood pressure and the amount of oxygen in the brain,therefore,can reduce the occurrence of postoperative complications.

关 键 词：颅内动脉瘤介入手术 七氟烷 控制性降压 脑耗氧量 

分 类 号：R614[医药卫生—麻醉学]