医药导报Issue(9)：1164-1169,6.DOI:10.3870/yydb.2014.09.012
七氟烷对冠心病颅脑手术患者行控制性降血压的脑保护作用
Neuroprotective Effect of Sevoflurane on Controlled Hypotension in Patients with Coronary Heart Disease Undergoing Craniocerebral Surgery
摘要
Abstract
Objective To study the neuroprotective effect of sevoflurane on controlled hypotension in patients with coronary heart disease undergoing craniocerebral surgery. Methods Twenty-six patients with coronary heart disease undergoing craniocerebral surgery were randomly divided into two groups,receiving either inhaled 2%-5%sevoflurane plus intravenous sodium nitroprusside (treatment group,n=13) or intravenous sodium nitroprusside 3-8 μg·kg-1 alone (contorl group,n=13) for blood pressure control. The hemodynamic changes were recorded during the operation. Patient satisfaction with surgeons and the duration hospital stay after surgery were recorded. The levels of cardiac troponin I (TNI),creatine kinase-MB (CK-MBM),neuron specific enolase ( NSE) and S100 calcium binding proteinβ( S-100βprotein) in serum were detected at one day pre-operation,the end of the operation,and one day post-operation. Results The duration of hospital stay after surgery was significantly shortened in treatment group [(20. 3±3. 8) versus (23. 9±4. 6) d,P<0. 05) compared with control group. The average heart rate significantly decreased, patient satisfaction significantly increased, and serum levels of NSE and S-100β protein one day post-operation significantly decreased as compared to control group (all P<0. 05). Compared with the day before operation,serum levels of NSE and S-100βprotein in the two groups increased significantly at the end of surgery (P<0. 05),and the levels of TNI,CK-MBM,NSE and S-100βsignificantly elevated one day post-operation (P<0. 05). Compared with the end of operation,serum levels of NSE and S-100βin contorl group incarcerated remarkably (P<0. 05) Conclusion Sevoflurane plays an important neuroprotective role,as evidenced by improving patients' satisfaction,reducing hospital stay after surgery,and maintaining the balance of myocardial oxygen delivery and consumption in craniocerebral surgery patients with coronary heart disease during controlled hypotension. However,it can not prevent postoperative myocardial injury in these patients.关键词
七氟烷/硝普钠/降血压,控制性/脑保护/钙结合蛋白质类/神经元特异性烯醇酶Key words
Sevoflurane/Sodium nitroprusside/Hypotension,controlled/Neuroprotection/Calcium-binding proteins/Neuron specific enolase分类
医药卫生引用本文复制引用
杨云朝,李进,丰新民..七氟烷对冠心病颅脑手术患者行控制性降血压的脑保护作用[J].医药导报,2014,(9):1164-1169,6.基金项目
武汉市卫生局科研基金资助项目(武卫[2010]42号WX10B02) （武卫[2010]42号WX10B02）
