摘要
目的:观察丙泊酚靶控输注联合右美托咪定对颅脑外伤颅内血肿清除术患者血清炎症因子和脑损伤指标的影响.方法:选择2016年3月～2021年5月期间联勤保障部队第901医院麻醉科收治的颅脑外伤颅内血肿清除术患者115例.采用随机数字表法将患者分为对照组和实验组,例数分别为57例和58例.对照组患者接受丙泊酚靶控输注,实验组患者接受丙泊酚靶控输注联合右美托咪定.对比两组苏醒质量(苏醒时间、听指令睁眼时间、滞留苏醒室时间)、血流动力学指标[心率(HR)、收缩压(SBP)、舒张压(DBP)]、炎症因子[白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)]、脑损伤指标[神经元特异性烯醇化酶(NSE)、S100β、脑源性神经营养因子(BDNF)]情况,同时观察两组围术期不良反应情况.结果:实验组的苏醒时间、听指令睁眼时间、滞留苏醒室时间短于对照组(P＜0.05).实验组气管插管时(T1)～拔管后(T4)时间点HR、SBP、DBP低于对照组(P＜0.05).实验组术后48hIL-1β、TNF-α、IL-6低于对照组(P＜0.05).实验组术后48hNSE、S100β低于对照组,BDNF高于对照组(P＜0.05).两组不良反应发生率组间对比未见差异(P＞0.05).结论:丙泊酚靶控输注联合右美托咪定应用于颅脑外伤颅内血肿清除术患者,可维持机体血流动力学稳定,减轻炎症反应和脑损伤,促进术后苏醒,且不良反应发生率无明显增加.
Abstract
Objective:To observe the effects of propofol target controlled infusion combined with dexmedetomidine on serum in-flammatory factors and brain injury indexes in patients with craniocerebral trauma intracranial hematoma removal.Methods:A total of 115 patients with intracranial hematoma removal for craniocerebral trauma admitted to the Department of Anesthesiology of the 901st Hospital of the Joint Logistics Support Force during 2016～2021 were selected.Patients were divided into control group and experimental group by random number table method,with 57 cases and 58 cases respectively.Patients in control group received propofol target con-trolled infusion,and patients in experimental group received propofol target controlled infusion combined with dexmedetomidine.The recovery quality(recovery time,listen to the instruction eye opening time,retention time in recovery room),hemodynamic indexes[heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP)],inflammatory factors[interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],brain injury indexes[neuron-specific enolase(NSE),S100β,brain-derived neurotrophic factor(BDNF)]were compared between two groups,and the perioperative adverse reactions in two groups were observed.Results:The recov-ery time,listen to the instruction eye opening time and retention time in recovery room in experimental group were shorter than those in control group(P＜0.05).HR,SBP and DBP in experimental group were lower than those in control group at the time point of tracheal in-tubation(T1)to extubation(T4)(P＜0.05).The levels of IL-1β,TNF-α and IL-6 in experimental group were lower than those in control group at 48h after operation(P＜0.05).The NSE and S100β in experimental group were lower than those in control group at 48 h after op-eration,and BDNF was higher than that in control group(P＜0.05).There was no difference in the incidence of adverse reactions between two groups(P＞0.05).Conclusion:Propofol target controlled infusion combine with dexmedetomidine for patients with craniocerebral trauma intracranial hematoma removal,which can maintain hemodynamic stability,reduce inflammatory response and brain injury,pro-mote recovery after operation,and the incidence of adverse reactions are not increase significantly.
基金项目
安徽省重点研发计划(201904a07020108)
维普
万方数据