七氟醚联合右美托咪定麻醉对颅内动脉瘤栓塞患者的神经保护作用分析  

Neuroprotective Effect of Sevoflurane Combined with Dexmedetomidine Anesthesia on Intracranial Aneurysm Embolization Patients

作　　者：杨黎明[1] 李兴[1] YANG Li-ming;LI Xing(Department of Anesthesiology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203)

机构地区：[1]上海中医药大学附属曙光医院麻醉科

出　　处：《中国现代手术学杂志》2019年第3期236-240,共5页Chinese Journal of Modern Operative Surgery

摘　　要：目的 分析七氟醚联合右美托咪定麻醉对颅内动脉瘤栓塞患者的神经保护作用。方法选取2017年3月~2019年3月期间于我院进行治疗的78例颅内动脉瘤栓塞的患者为研究对象,按照随机数字表法分为实验组和对照组,每组39例。对照组予七氟醚和生理盐水联合麻醉,实验组予七氟醚和右美托咪定联合麻醉,比较两组患者麻醉前(T0)、麻醉诱导时(T1)、麻醉喉罩置入时(T2)、股动脉插管后(T3)、手术结束(T4)、喉罩吸氧去除后(T5)、喉罩吸氧去除后10 min(T6)6个时间节点的血流动力学变化(心率、舒张压、收缩压、血氧饱和度),血葡萄糖、乳酸含量,血清S100β、NSE含量,呼气末七氟醚浓度,累积七氟醚的消耗量及不良反应。结果 实验组患者6个时间点(T1~T6)的心率、舒张压、收缩压明显低于对照组(P<0.05);实验组患者T1、T5 2个时间点的血葡萄糖、乳酸、血清S100β、NSE含量明显低于对照组(P<0.05);实验组患者T2、T3、T4 3个时间点的呼气末七氟醚浓度明显低于对照组;实验组患者累积七氟醚的消耗量及不良反应发生率明显低于对照组(P<0.05)。结论 七氟醚联合右美托咪定麻醉在颅内动脉瘤栓塞术中的麻醉效果显著,可维持血流动力学的稳定,具有较强的神经保护作用,且安全有效。Objective To analyze the neuroprotective effects of sevoflurane combined with dexmedetomidine anesthesia on patients with intracranial aneurysm embolization.Methods 78 patients with intracranial aneurysm embolization who were treated in our hospital from March 2017 to March 2019 were selected as the study subjects.The patients were divided into the experimental group and the control group according to the random number table method,with 39 cases in each.The control group was given anesthesia with sevoflurane and normal saline,and the experimental group was given anesthesia with sevoflurane and dexmedetomidine.It was compared in hemodynamic changes,blood concentrations of glucose,lactic acid,S100β and NSE,and the end-tidal sevoflurane concentration at time points of baseline condition before anesthesia(T0),induction of anesthesia(T1),placement of anesthesia laryngeal mask(T2),post-cannulation of femoral artery (T3),end of surgery(T4),removal of oxygen from the laryngeal mask(T5),and 10 minutes after oxygen removal of the laryngeal mask(T6),and the accumulated sevoflurane consumption and adverse reactions were compared between the two groups as well.Results The heart rate,diastolic blood pressure and systolic blood pressure of the experimental group were significantly lower than that of the control group at T1~T6 (P<0.05).The levels of glucose,lactate,S100β and NSE in the experimental group were significantly lower than that of the control group at T1 and T5(P<0.05).The concentration of end-tidal sevoflurane in the experimental group at T2,T3,and T4 was significantly lower than that of the control group;and the cumulative consumption of sevoflurane and the incidence of adverse reactions in the experimental group were significantly lower than that of the control group (P<0.05).Conclusion The sevoflurane combined with dexmedetomidine anesthesia has a significant anesthetic effect in intracranial aneurysm embolization with stable hemodynamics and neuroprotective effects.It is proved safe and effective.

关 键 词：七氟醚 右美托咪定 颅内动脉瘤栓塞术 神经保护 

分 类 号：R614.2[医药卫生—麻醉学] R743.4[医药卫生—外科学]