七氟醚吸入麻醉对急性颅内出血开颅手术患者的脑保护作用  

Cerebral Protection Effect of Sevoflurane Inhalation Anesthesia on Patients with Acute Intracranial Hemorrhage

作　　者：李勇 葛运杰 LI Yong;GE Yun-jie(Department of Anesthesiology,Shanxian Central Hospital,Shanxian,Shandong Province,274300 China;Department of Anesthesiology,Shanxian DongdaHospital,Shanxian,Shandong Province,274300 China)

机构地区：[1]单县中心医院麻醉科,山东单县274300 [2]单县东大医院麻醉科,山东单县274300

出　　处：《中外医疗》2019年第11期4-6,共3页China & Foreign Medical Treatment

摘　　要：目的研究探讨七氟醚吸入麻醉对急性颅内出血开颅手术患者的脑保护作用。方法方便选择该院就诊且行开颅手术治疗的60例急性颅内出血患者(2017年1月—2018年9月),随机分为两组各30例,对照组采用丙泊酚持续泵注,观察组采用丙泊酚低浓度泵入、七氟醚吸入,比较麻醉效果、血清炎症因子指标、脑损伤指标、认知功能评分。结果①组间麻醉效果比较,观察组、对照组的麻醉优良率分别为96.67%、93.33%,差异无统计学意义(χ^2=0.351,P>0.05)。②手术后,观察组的CRP(5.87±1.32)mg/L、IL-6(23.49±3.24)ng/L、S100β(0.45±0.12)μg/L、NSE(37.21±8.76)μg/L均低于对照组(t=4.128、4.026、3.862、4.301,P<0.05),其MMSE评分(23.95±2.13)分、MoCA评分(21.60±2.81)分均高于对照组(t=6.628、3.970,P<0.05)。结论七氟醚吸入麻醉用于急性颅内出血患者开颅手术中的麻醉效果良好,可发挥良好的脑保护作用。Objective To investigate the protective effect of sevoflurane inhalation anesthesia on patients with acute intracranial hemorrhage. Methods 60 patients with acute intracranial hemorrhage who were treated with craniotomy in our hospital (January 2017 to September 2018) were convenient divided into two groups of 30 patients each. The control group was continuously pumped with propofol. The observation group was treated with low concentration of propofol and sevoflurane inhalation. The anesthetic effect, serum inflammatory factor index, brain injury index and cognitive function score were compared. Results 1.The anesthetic rate of the observation group and the control group were 96.67% and 93.33%, respectively. The difference was not statistically significant (χ^2=0.351, P>0.05). 2.After surgery, the CRP (5.87±1.32)ng/L, IL-6 (23.49±3.24)ng/L, S100β(0.45±0.12)μg/L, and NSE (37.21±8.76)μg/L in the observation group were lower than the control group (t=4.128, 4.026, 3.862, 4.301, P<0.05), the MMSE score (23.95±2.13)points and MoCA score (21.60±2.81)points were higher than the control group (t=6.628, 3.970, P<0.05). Conclusion Sevoflurane inhalation anesthesia is effective for craniotomy in patients with acute intracranial hemorrhage, and it can exert good brain protection.

关 键 词：急性颅内出血 开颅手术 麻醉 七氟醚 脑保护 

分 类 号：R5[医药卫生—内科学]