丙泊酚联合羟考酮对急性颅脑损伤患者炎性反应及应激反应的影响  

Effect of propofol combined with oxycodone on inflammatory reactions and stress reactions in patients with acute craniocerebral injury

作　　者：常丙林[1] 张浩 CHANG Binglin;ZHANG Hao(Department of Neurosurgery,Anyang District Hospital in Puyang City of Henan Province,Anyang,Henan,455000)

机构地区：[1]河南省濮阳市安阳地区医院神经外科,河南安阳455000

出　　处：《实用临床医药杂志》2021年第2期25-27,31,共4页Journal of Clinical Medicine in Practice

摘　　要：目的探讨丙泊酚联合羟考酮对急性颅脑损伤患者炎性反应及应激反应的影响。方法将95例急性颅脑损伤患者随机分为对照组47例(给予丙泊酚联合瑞芬太尼麻醉)和观察组48例(给予丙泊酚联合盐酸羟考酮麻醉)。比较2组患者的麻醉效果、镇痛效果、脑组织氧化应激反应、不良反应。结果观察组术后麻醉呼吸恢复时间、拔管时间、开眼时间、平均动脉压(MAP)及心率(HR)短于、低于对照组,差异有统计学意义(P<0.05);观察组术后1、6、12、24 h的疼痛视觉模拟评分法(VAS)评分均低于对照组,差异有统计学意义(P<0.05);观察组术中及术后24 h的髓鞘碱性蛋白(MBP)、神经元特异性烯醇化酶(NSE)、S-100B蛋白、D-二聚体(D-D)水平均低于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率为10.42%,低于对照组的27.66%,差异有统计学意义(P<0.05)。结论丙泊酚联合羟考酮可降低急性颅脑损伤患者脑组织氧化应激反应程度,提高麻醉和镇痛效果,且不良反应较少。Objective To investigate the effect of propofol combined with oxycodone on inflammatory reactions and stress reactions in patients with acute craniocerebral injury.Methods Totally 95 patients with acute craniocerebral injury were randomly divided into control group(n=47,treated by propofol and remifentanil for anesthesia)and observation group(n=48,treated by propofol and oxycodone hydrochloride for anesthesia).The anesthetic effect,analgesic effect,oxidative stress reactions of brain tissues and adverse reactions were compared between the two groups.Results The postoperative recovery time of anesthesia,extubation time,eye-opening time,mean arterial pressure(MAP)and heart rate(HR)of the observation group were significantly shorter or lower than those of the control group(P<0.05).The VAS scores of the observation group at 1 hour,6,12 and 24 hours after operation were significantly lower than those of the control group(P<0.05).The levels of myelin basic protein(MBP),neuron specific enolase(NSE),S-100B protein and D-dimer(D-D)in the observation group were significantly lower than those in the control group during operation and 24 hours after operation(P<0.05).The incidence of adverse reactions in the observation group was 10.42%,which was significantly lower than 27.66%in the control group(P<0.05).Conclusion Propofol combined with oxycodone can reduce the oxidative stress degree of brain tissue in patients with acute craniocerebral injury,improve the effects of anesthesia and analgesia,and cause less adverse reactions.

关 键 词：丙泊酚 羟考酮 急性颅脑损伤 炎性反应 应激反应 

分 类 号：R614[医药卫生—麻醉学] R651.1[医药卫生—外科学]