静吸复合维持麻醉对脑膜瘤手术患者血流动力学及脑氧代谢的影响  

Effect of Intravenous Inhalation Combined with Maintenance Anesthesia on Hemodynamics and Cerebral Oxygen Metabolism in Patients with Meningioma Surgery

作　　者：李永强[1] 吴悠 白娜 沈彦波[1] LI Yongqiang;WU You;BAI Na;SHEN Yanbo(Department of Anesthesia,Luohe Central Hospital,Luohe 462000,China)

机构地区：[1]漯河市中心医院麻醉科,河南漯河462000

出　　处：《河南医学研究》2023年第13期2393-2397,共5页Henan Medical Research

摘　　要：目的观察采用静吸复合维持麻醉对脑膜瘤手术患者血流动力学及脑氧代谢的影响。方法选取2019年10月至2021年10月漯河市中心医院收治的104例择期行手术治疗的脑膜瘤患者为研究对象,采用抽签法将患者分为对照组与观察组,各52例。两组均接受外科手术治疗,术中对照组行全凭静脉维持麻醉,观察组行静吸复合维持麻醉。采用广义估计方程分析两组插管前(T_(0))、插管后5 min(T_(1))、拔管后即刻(T_(2))、术毕(T_(3))的血流动力学[平均动脉压(MAP)、心率(HR)]、脑氧代谢[动脉含氧量(CaO_(2))、颈内静脉静脉球部血氧含量(CjvO_(2))、脑氧摄取率(CEO_(2))],并比较两组术后24 h内不良反应情况。结果T_(2)时,两组MAP值较T_(0)、T_(1)时均降低,且观察组T_(1)、T_(2)时MAP值均高于对照组(P<0.05);T_(3)时,两组MAP值较T_(2)时均升高(P<0.05);T_(1)、T_(2)时,两组HR值较T_(0)时均降低(P<0.05);T_(2)、T_(3)时,两组HR值较T_(1)时均降低(P<0.05);T_(3)时,两组HR值较T_(2)时均升高(P<0.05);但T_(0)、T_(1)、T_(2)、T_(3)时,两组HR值比较,差异无统计学意义(P>0.05)。较T_(0)时,两组T_(2)时CaO_(2)降低,T_(1)时CjvO_(2)升高,T_(1)、T_(2)时CEO_(2)降低(P<0.05);较T_(1)时,两组T_(2)、T_(3)时CaO_(2)、CjvO_(2)值均降低,T_(3)时CEO_(2)升高(P<0.05);但T_(0)、T_(1)、T_(2)、T_(3)时,两组CaO_(2)、CjvO_(2)、CEO_(2)值比较,差异无统计学意义(P>0.05)。术后24 h内,两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论静吸复合维持麻醉可维持脑膜瘤手术患者血流动力学的稳定,且在维持脑氧代谢效果方面与全凭静脉维持麻醉效果相似。Objective To observe the effect of intravenous inhalation combined with maintenance anesthesia on hemodynamics and cerebral oxygen metabolism in patients with meningioma surgery.Methods A total of 104 patients with meningiomas who underwent elective surgery in Luohe Central Hospital from October 2019 to October 2021 were selected as the research subjects,and they were divided into control group and observation group by drawing lot method,with 52 cases in each group.Both groups received surgical treatment.During the operation,the control group received total intravenous maintenance anesthesia,and the observation group received intravenous inhalation combined with maintenance anesthesia.The hemodynamics[mean arterial pressure(MAP),heart rate(HR)],cerebral oxygen metabolism[arterial oxygen content(CaO_(2)),blood oxygen content of internal jugular vein bulb(CjvO_(2)),cerebral oxygen uptake rate(CEO_(2))]before intubation(T_(0)),5 minutes after intubation(T_(1)),immediately after extubation(T_(2))and at the end of operation(T_(3))between the two groups were analyzed by generalized estimation equation,and the adverse reactions within 24 hours after operation were compared between the two groups.Results At T_(2),the MAP value of the two groups was lower than that of T_(0) and T_(1),and the MAP value of the observation group at T_(1) and T_(2) was higher than that of the control group(P<0.05).At T_(3),the MAP value of both groups was higher than that at T_(2)(P<0.05).At T_(1) and T_(2),HR values in both groups were lower than those at T_(0)(P<0.05).At T_(2) and T_(3),HR values in both groups were lower than those at T_(1)(P<0.05).At T_(3),HR value of both groups was higher than that at T_(2)(P<0.05).However,at T_(0),T_(1),T_(2) and T_(3),there was no statistical significant difference in HR values between the two groups(P>0.05).Compared with T_(0),CaO_(2) in the two groups decreased at T_(2),CjvO_(2) increased at T_(1),and CEO_(2) decreased at T_(1) and T_(2)(P<0.05).Compared with T_(1),CaO_(2) and CjvO_(2) values at T_(

关 键 词：脑膜瘤 静吸复合维持麻醉 全凭静脉维持麻醉 血流动力学 脑氧代谢 

分 类 号：R614[医药卫生—麻醉学]