摘要:
目的 探讨三种不同麻醉方法对重症颅脑损伤患者氧分压及代谢的影响.方法 78例颅脑重症损伤患者分为A组(丙泊酚静脉全凭麻醉)、B组(七氟烷吸入全麻)和C组(静吸复合全麻).比较3组患者于麻醉前(T0)、插管前即刻(T1)、插管后2 min(T2)、手术开始后10 min(T3)、手术开始后30 min(T4)及术毕(T5)时的有创血压平均动脉压(MAP)、心率(HR)、颈内静脉血氧含量(Cjv02)、桡动脉血氧含量(Ca02)、脑氧摄取率(CER02).结果 与T0、T1比较,3组患者T2～ T5的MAP均显著下降(F=5.112、4.040、4.301,P=0.0002、0.0018、0.0011).麻醉后,3组患者Sjv02均显著上升(F=3.833、3.322、8.114,P=0.0027、0.0071、＜0.0001),Da-jvO2均显著降低(F=3.127、2.635、4 886,p=0.0094、0.0258、0.0004),CER02均显著减小(F=14.37、8.805、25.72,P＜0.01).结论 丙泊酚静脉全凭麻醉、七氟烷吸入全麻和静吸复合全麻均具有良好的脑保护作用.
Abstract:
Objective To explore effects of three different anesthetic methods on cerebral oxygen partial pressure and cerebral oxygen metabolism in patents with severe traumatic brain injury.Methods A total of 78 patients with severe traumatic brain injury were randomly divided into group A (total intravenous anesthesia),group B (sevoflurane inhalation anesthesia) and group C (combined inhalation and intravenous anesthesia).Mean arterial pressure (MAP),heart rate (HR),jugular vein blood oxygen content (CjvO2),radial artery blood oxygen content (CaO2) and cerebral extraction of oxygen (CERO2) were observed in all groups at the time points of pre intubation (T0),pre anesthesia induction (T1),2 minutes after anesthesia induction (T2),10 minutes after surgery begin (T3),30 minutes after surgery begin (T4),end of surgery (T5).Results Compared with T0 and T1,MAP in all groups at T2 to T5 significantly decreased (F =5.112,4.040,4.301;P =0.0002,0.0018,0.0011).In all groups,SjvO2 significantly increased after anesthesia (F =3.833,3.322,8.114;P=0.0027,0.0071,＜0.0001),Da-jvO2(F=3.127,2.635,4.886;P=0.0094,0.0258,0.0004) and CERO2 (F =14.37,8.805,25.72;P ＜ 0.01) significantly decreased.Conclusion Propofol intravenous anesthesia,sevoflurane inhalation anesthesia and general anesthesia combined with intravenous anesthesia have good brain protection effects.
百度学术
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