环泊酚复合瑞芬太尼在颅脑损伤手术患者中的应用  

Application of Cipepofol Combined with Remifentanil in Patients with Craniocerebral Injury Undergoing Surgery

作　　者：舒娟 韩菲菲 李勇 肖霄 彭志宏 SHU Juan;HAN Fei-fei;LI Yong;XIAO Xiao;PENG Zhi-hong(Department of Anesthesiology,Xinyang Central Hospital,Xinyang 464000,China)

机构地区：[1]信阳市中心医院麻醉科,信阳464000

出　　处：《中国合理用药探索》2025年第2期62-67,共6页Chinese Journal of Rational Drug Use

摘　　要：目的:探讨环泊酚复合瑞芬太尼在颅脑损伤手术患者中的应用效果。方法:选取2021年6月1日~2023年6月30日期间某院收治的96例颅脑损伤患者作为研究对象,采用随机数字表法分为对照组和观察组,每组48例。对照组患者给予丙泊酚乳状注射液复合注射用盐酸瑞芬太尼全身麻醉方案,观察组患者给予环泊酚注射液复合注射用盐酸瑞芬太尼全身麻醉方案。比较两组患者麻醉诱导前(T_(0))、麻醉诱导1min(T_(1))、气管插管时(T_(2))、硬脑膜剪开时(T_(3))、手术结束时的血流动力学指标(心率、平均动脉压);T_(0)、手术结束时、术后1天时神经功能[神经元特异性烯醇化酶(NSE)、S100β]、氧化应激指标[超氧化物歧化酶(SOD)]、炎症因子[超敏C反应蛋白(hs-CRP)]水平、术后3个月时苏醒率及苏醒患者的简易精神状态检查(MMSE)评分。结果:两组患者T_(2)时心率均高于T_(0)、T_(1)(P<0.05);T_(3)时对照组患者心率低于T_(0)、T_(1)、T_(2)(P<0.05);两组患者各时间点心率比较均无统计学差异(P>0.05);两组患者T_(2)时平均动脉压高于T_(1)、T_(0)(P<0.05),T_(3)时平均动脉压低于T_(2)(P<0.05);观察组患者T_(3)时平均动脉压高于对照组(P<0.05);观察组患者手术结束时、术后1天时NSE、hs-CRP、S100β水平均低于对照组(P<0.05),SOD水平高于对照组(P<0.05);两组患者苏醒率比较无统计学差异(P>0.05);观察组术后苏醒患者MMSE评分高于对照组(P<0.05)。结论:环泊酚复合瑞芬太尼可稳定颅脑损伤手术患者血流动力学稳定,减轻氧化应激、炎症损伤,且有助于患者术后认知功能的恢复。Objective:To investigate the application effect of cipepofol combined with remifentanil in patients with craniocerebral injury undergoing surgery.Methods:A total of 96 patients with craniocerebral injury treated in a hospital from June 1,2021 to June 30,2023 were selected and assigned to the control group and observation group by random number table method,with 48 patients in each group.The control group was given propofol injectable emulsion combined with remifentanil hydrochloride for injection for general anaesthesia,and the observation group was given cipepofol injection combined with remifentanil hydrochloride for injection for general anaesthesia.The hemodynamic parameters(heart rate,mean arterial pressure)before induction of anaesthesia(T_(0)),at 1 min after induction of anaesthesia(T_(1)),at tracheal intubation(T_(2)),at dural incision(T_(3))and at the end of surgery,neurological function[neuron-specific enolase(NSE),S100β],oxidative stress index[superoxide dismutase(SOD)],inflammatory factor[hypersensitive C-reactive protein(hs-CRP)]levels at T_(0),at the end of surgery and at 1 day after surgery,recovery rate and mini-mental state examination(MMSE)score in recovered patients at 3 months after surgery were compared between the two groups.Results:The heart rate at T_(2) was higher than that at T_(0) and T_(1) in both groups(P<0.05).The heart rate in control group at T_(3) was lower than that at T_(0),T_(1) and T_(2)(P<0.05).There was no statistically significant difference in heart rate at each time point between the two groups(P>0.05).The mean arterial pressure in the two groups at T_(2) was higher than that at T_(1) and T_(0)(P<0.05),and the mean arterial pressure at T_(3) was lower than that at T_(2)(P<0.05).The mean arterial pressure at T_(3) in the observation group was higher than that in the control group(P<0.05).The levels of NSE,hs-CRP and S100βat the end of surgery and at 1 day after surgery in the observation group were lower than those in the control group(P<0.05),and the level of SOD was hi

关 键 词：颅脑损伤 瑞芬太尼 环泊酚 脑代谢 血流动力学 

分 类 号：R651.15[医药卫生—外科学]