瑞芬太尼联合异丙酚对颅内动脉瘤夹闭术患者麻醉效果及血清S100β、NSE水平的影响  

Effect of Remifentanil Combined with Propofol on Anesthesia Effect and Serum Levels of S100β and NSE in Patients Undergoing Intracranial Aneurysm Clipping

作　　者：彭元明[1] 刘芝[1] 胡涛 黄晓玲[1] 陈文雁[1] PENG Yuan-ming;LIU Zhi;HU Tao;HUANG Xiao-ling;CHEN Wen-yan(Department of Anesthesiology,People's Hospital of Hunan Province,Changsha,Hunan,410000,China)

机构地区：[1]湖南省人民医院麻醉科,湖南长沙410000

出　　处：《现代生物医学进展》2020年第6期1099-1102,共4页Progress in Modern Biomedicine

基　　金：湖南省卫计委科研计划项目(B2017089)。

摘　　要：目的:探讨瑞芬太尼联合异丙酚对全麻下颅内动脉瘤夹闭术患者麻醉效果及血清中枢神经特异蛋白(S100β)、神经元特异性烯醇化酶(NSE)的影响。方法:选取2017年2月~2019年1月期间于我院行全麻下颅内动脉瘤夹闭术的患者103例,根据随机数字表法将患者分为对照组(n=51)和研究组(n=52),对照组给予异氟醚联合异丙酚麻醉,研究组给予瑞芬太尼联合异丙酚麻醉,比较两组患者麻醉效果、再出血率及血清S100β、NSE水平。结果:研究组硬脑膜切开前(T2)~动脉瘤夹闭即刻(T4)时间点心率(HR)、中心静脉压(MAP)均低于对照组(P<0.05)。研究组自主呼吸恢复时间、定向力恢复时间、呼吸后睁眼时间、气管拔管时间、离开手术室时间均短于对照组(P<0.05)。研究组T2~手术结束时(T5)时间点血清S100β、NSE水平低于对照组(P<0.05)。两组再出血率比较差异无统计学意义(P>0.05)。结论:瑞芬太尼联合异丙酚可改善全麻下颅内动脉瘤夹闭术患者的术后指标,维持血流动力学平稳,减轻脑损害。Objective: To investigate the effects of remifentanil combined with propofol on anesthesia effect and serum levels of central nerve specific protein(S100β) and neuron specific enolase(NSE) in patients undergoing general anesthesia for intracranial aneurysm clipping. Methods: 103 patients undergoing general anesthesia for intracranial aneurysm clipping who were treated in our hospital from February 2017 to January 2019 were selected, and they were divided into control group(n=51) and study group(n=52) according to random number table method. The control group was given isoflurane combined with propofol under anesthesia, and the study group was given remifentanil combined with propofol under anesthesia. The anesthetic effect, rebleeding rate, serum levels of S100β, NSE were compared between the two groups. Results: Heart rate(HR) and central venous pressure(MAP) in the study group from before dural incision(T2) to immediately after aneurysm clipping(T4) were lower than those in the control group(P<0.05). The recovery time of spontaneous breathing, recovery time of orientation, time of opening eyes after breathing, time of tracheal extubation and time of leaving the operating room in the study group were shorter than those in the control group(P<0.05). The levels of serum S100β and NSE in the study group from T2 to the end of operation(T5) were lower than those in the control group(P<0.05). There was no significant difference in the rebleeding rate between the two groups(P>0.05). Conclusion: Remifentanil combined with propofol for patients undergoing general anesthesia for intracranial aneurysm clipping can improve the postoperative indicators of patients, maintain stable hemodynamics, alleviate brain damage.

关 键 词：瑞芬太尼 异丙酚 颅内动脉瘤夹闭术 麻醉 中枢神经特异蛋白 神经元特异性烯醇化酶 

分 类 号：R739.41[医药卫生—肿瘤] R614[医药卫生—临床医学]