不同氧浓度对颅脑手术患者血浆超氧化物歧化酶和丙二醛的影响及其脑保护作用  

Effect of oxygen of different concentration on serum superoxide dismutase and malondialdehyde and its protection to brain in patients undergoing operation on cranium

作　　者：王保华[1] 王其春[2] 牛春风[1] 周春燕[3] 

机构地区：[1]长春中医学院附属医院麻醉科,吉林省长春市130021 [2]长春中医学院附属医院外二科,吉林省长春市130021 [3]吉林大学第一医院麻醉科,吉林省长春市130021

出　　处：《中国临床康复》2003年第31期4210-4212,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:通过观察不同氧浓度对颅脑手术患者血浆中超氧化物歧化酶(SOD)和丙二醛浓度的影响来探讨吸氧对脑保护的作用。方法32例ASAⅠ～Ⅱ级择期行颅脑手术患者随机分为A,B,C,D4组,每组8例,全麻插管后行控制呼吸。麻醉中A,B,C3组患者均吸入O2-N2O混合气体,氧浓度分别为35%,50%,75%,D组吸纯氧。A组为对照组,B,C,D组为实验组。分别于麻醉前、麻醉诱导后30,60,90,120min和拔管后10min采静脉血测定血浆中SOD和丙二醛值。结果:四组患者随着吸氧时间的延长和吸氧浓度的增加SOD活力逐渐降低,丙二醛浓度逐渐增加。C,D组患者拔管后10minSOD活力犤(65.678±19.993)NU/mL,(61.591±13.887)NU/mL〗较A组犤(81.715±16.270)NU/mL犦显著降低(P<0.05或0.01),丙二醛含量犤(7.314±1.232),(7.485±1.312)μmol/L〗较A组犤(5.679±1.397)μmol/L〗显著升高(P<0.05或0.01)。结论:颅脑手术中当吸氧浓度≥50%时对患者血浆中SOD和丙二醛的影响较为严重,吸氧浓度<50%对脑保护更为有利。AIM:To explore the protective effect of oxygen inhalation to brain by observing the effect of inhaled oxygen of different concentration on the concentration of serum superoxide dismutase (SOD)and malondialdehyde(MDA) in patients undergoing operation on cranium. METHODS:Thirty two patients (ASAⅠ-Ⅱ) scheduled to undergo operation on cranium were divided into group A(control group), B, C and D (study group), 8 in each group, their respiration were controlled after complete anesthesia and intubation. Different inhaled oxygen concentration are generated by inhaling mixture of O2 and N2O: group A 35%,group B 50%, group C 75%, patients in group D inhaled 100%O2 without N2O. SOD and MDA in venous blood were assessed before anesthesia, 30, 60, 90,120 min after anesthesia intubation and 10 min after extubation. RESULTS:The activity of serum SOD decreased and the concentration of serum MDA increased gradually along with the extension of time and increase of inhaled oxygen concentration, in all the 4 groups.The activity of SOD 10 min after extubation in group C and D [(65.678±19.993)NU/mL,(61.591±13.887) NU/mL] were significantly lower than that in group A[(81.715±16.270)NU/mL] (P< 0.05, 0.01), while the concentration of MDA in group C and D [(7.314±1.232),(7.485±1.312)μmol/L]were significantly higher than that in group A[(5.679±1.397)μmol/L] (P< 0.05, 0.01). CONCLUSION:The serum SOD and MDA can be influenced more seriously, when the inhaled oxygen concentration comes up to 50%or more. It is better for the protective effect of brain to inhale oxygen with the concentration less than 50%.

关 键 词：氧浓度 颅脑手术 血浆 超氧化物歧化酶 丙二醛 脑保护作用 SDD 血糖 

分 类 号：R651.11[医药卫生—外科学]