急性颅内出血开颅手术应用七氟醚的效果及其对患者血清神经功能指标及炎症因子的影响  

Effect of sevoflurane in craniotomy for acute intracranial hemorrhage and its influence on serum nerve function indexes and inflammatory factors

作　　者：刘鹏森 Liu Pengsen(Department of Anesthesiology, the second affiliated Hospital of Henan University of traditional Chinese Medicine ,Zhengzhou 450052, China)

机构地区：[1]河南中医药大学第二附属医院麻醉科,郑州450000

出　　处：《河南外科学杂志》2019年第2期1-3,共3页Henan Journal of Surgery

摘　　要：目的探讨急性颅内出血开颅手术应用七氟醚的效果及其对患者血清神经功能指标及炎症因子的影响。方法将接受开颅手术治疗的90例急性颅内出血患者随机分为2组,各45例。对照组行丙泊酚、瑞芬太尼静脉全麻,观察组行七氟醚、丙泊酚、瑞芬太尼静吸复合全麻。比较2组麻醉诱导前10 min(T_0)、手术开始后90 min(T_1)、手术结束(T_2)、术后24 h(T_3)患者的颅内压、血清神经功能指标及炎症因子水平。结果 (1)T_0～T_2时,2组患者颅内压差异无统计学意义(P>0.05)。T_3时观察组颅内压显著低于对照组,差异有统计学意义(P<0.05)。(2)T_0时2组患者血清神经元特异性烯醇化酶(NSE)、S-100β蛋白、α-肿瘤坏死因子(TNF-α)、白介素-6(IL-6)差异无统计学意义(P>0.05)。T_1～T_3时,观察组血清NSE、S-100β蛋白、TNF-α、IL-6显著低于对照组,差异有统计学意义(P<0.05)。结论急性颅内出血开颅手术应用七氟醚麻醉,具有脑组织损伤小、炎症反应轻等优点,效果确切。Objective To investigate the effect of sevoflurane in craniotomy for acute intracranial hemorrhage and its influence on serum nerve function indexes and inflammatory factors.Methods Totally 90 cases of acute intracranial hemorrhage treated by craniotomy were randomly divided into two groups, 45 cases in each group. Control group received propofol, remifentanil intravenous general anesthesia, observation group received sevoflurane, propofol, remifentanil intravenous inhalation combined general anesthesia. The intracranial pressure, serum nerve function and inflammatory factors were compared between the two groups 10 min(T0) before anesthesia induction, 90 min(T1), 90 min(T1) after operation, and 24 hours after operation(T3).Results(1)From T0 to T2, there were no obvious differences in the intracranial pressure between the 2 groups(P>0.05). At T3, the intracranial pressure of observation group was obviously lower than that of control group(P<0.05).(2)At T0, there were no obvious differences in the serum neuron specific enolase(NSE), S-100β protein,α-tumor necrosis factor alpha(TNF-α) and interleukin-6(IL-6) between the 2 groups(P>0.05). From T1 to T3, the serum NSE, S-100β protein, TNF-α and IL-6 in observation group was obviously lower than those of control group,respectively(P<0.05).Conclusion The sevoflurane in craniotomy for acute intracranial hemorrhage shows good effect, which has some advantages such as milder brain tissue injury and inflammatory response.

关 键 词：急性颅内出血 开颅手术 七氟醚 神经功能指标 炎症因子 

分 类 号：R614.2[医药卫生—麻醉学]