丙泊酚与七氟烷联合瑞芬太尼用于开颅手术中对患者血流动力学及神经功能的影响  

Effect of Propofol and Sevoflurane Combined with Remifentanil on Hemodynamics and Nerve Function in Patients Undergoing Craniotomy

作　　者：陶凤禹 周巧林 朱其飞 汪涛 TAO Fengyu;ZHOU Qiaolin;ZHU Qifei(Department of Anesthesiology,Affiliated Shuyang Hospital of Xuzhou Medical University,Shuyang Jiangsu 223600)

机构地区：[1]徐州医科大学附属沭阳医院麻醉科,江苏沭阳223600

出　　处：《医学临床研究》2025年第1期75-77,81,共4页Journal of Clinical Research

摘　　要：【目的】探讨丙泊酚与七氟烷联合瑞芬太尼对开颅手术患者血流动力学及神经功能的影响。【方法】100例行开颅手术的患者,随机分为观察组(采用丙泊酚联合瑞芬太尼麻醉)和对照组(采用七氟烷联合瑞芬太尼麻醉),每组50例。比较两组手术情况,各时间点血流动力学[心率(HR)、平均动脉压(MAP)]、手术前后应激反应指标[皮质醇(COR)、血糖(GLU)、促肾上腺皮质激素(ACTH)]、神经功能指标[特异性烯醇化酶(NSE)、S100β蛋白]及术后不良事件发生率。【结果】观察组术后清醒及拔管时间短于对照组(P<0.05);两组各时间点MAP、HR比较,差异无统计学意义(P>0.05);术中,两组COR、GLU、ACTH水平均高于手术前(P<0.05),观察组低于对照组(P<0.05);术中,两组NSE、S100β蛋白均高于手术前(P<0.05),观察组低于对照组(P<0.05);两组术后不良事件发生率比较,差异无统计学意义(P>0.05)。【结论】开颅手术中使用丙泊酚与七氟烷联合瑞芬太尼均可获得良好的麻醉效果,可维持患者血流动力学稳定,但丙泊酚联合瑞芬太尼更利于减轻患者应激反应,保护神经功能。【Objective】To investigate the effects of propofol and sevoflurane combined with remifentanil on hemodynamics and nerve function in patients undergoing craniotomy.【Methods】A total of 100 patients undergoing craniotomy were randomly divided into the observation group(propofol combined with remifentanil)and the control group(sevoflurane combined with remifentanil),with 50 cases in each group.The operation conditions were compared between the two groups in terms of hemodynamics at each time point[Heart rate(HR),mean arterial pressure(MAP)],stress responses before and after surgery[cortisol(COR),blood glucose(GLU),adrenocorticotropin(ACTH)],neural function[Specific enolase(NSE),S100βprotein]indicators and incidence of postoperative adverse events.【Results】Postoperative wakefulness and extubating time in the observation group were shorter than those in the control group(P<0.05).There was no significant difference in MAP and HR between the two groups at each time point(P>0.05).During operation,COR,GLU and ACTH in both groups were higher than before operation(P<0.05),and the observation group was lower than the control group(P<0.05).During operation,NSE and S100βprotein in both groups were higher than before operation(P<0.05),and the observation group was lower than the control group(P<0.05).There was no significant difference in the incidence of adverse events between the two groups(P>0.05).【Conclusion】The use of propofol and sevoflurane combined with remifentanil in craniotomy can achieve good anesthetic effects and maintain the hemodynamic stability of patients,but propofol combined with remifentanil is more conducive to reducing the stress response of patients and protecting nerve function.

关 键 词：颅骨切开术 二异丙酚 氟烷 瑞芬太尼 血流动力学 神经系统 

分 类 号：R651.1[医药卫生—外科学]