摘要
目的观察异丙酚和异氟醚麻醉对顿脑损伤患者围术期m清热休克蛋白70（HSP70）水平的影响。方法选择行开颅血肿清除术治疗的巾、重型急性帧脑损伤患者30例，按随机数字表法分为异丙酚组和异氟醚组，每组15例。麻醉诱导后前组患者静脉靶控输注异丙酚（效应室靶浓度为3～4μg／m1），后组患者吸入1．2％异氟醚，并且均间断静注维库溴铵、芬太尼维持麻醉深度.应用ELISA法测定患者麻醉诱导前、打开硬脑膜后1h、术后24h血液HSP70的含量，记录患者的术后苏醒时间和气管导管拔除时间：结果2组患者麻醉诱导前、打开硬腑膜后1h、术后24h血液HSP70含量随时间的推移均增加，差异有统计学意义（P〈0．05），与异氟醚组比较，异丙酚组患者存打开硬脑膜后111和术后24h时血液HSP70含量较高[（2．004-0．24）ng/ml，（2．19±0．26）ng／ml，t=2．080，P=0．047；（3．57±0．32）ng／ml，（3．81±0．31）ng/ml，t=2．086．P=0．0461，术后苏醒时间和气管导管拔除时间较短[（7．7±2．8）min，（5．6±2．7）min，t=2．091，P=0．046；（8．9±3．9）min，（6．0±3．6）min，t=2．116，P=0．043）]，差异有统计学意义（P〈0．05）。结论静脉靶控输注异丙酚麻醉可维持颅脑损伤患者围术期适度的应激状态。
Objective To investigate the effect of propofol and isoflurane anesthesia on serum heat shock protein 70 （HSP70） of perioperative patients with brain injury and compare the anesthetic effect of the two narcotic drugs. Methods 30 patients with medium or severe traumatic brain injnry, treated bv hematoma evacuation opera- tion,were randomly divided into propofnl （ n = 15） and isoflurane group（ n = 15 ）. After anesthesia induction, propofol （target effect concentration of 3 -4 μg/ml） was intravenously injected and 1.2% isoflurane was inhalated into the patients of the 2 groups,respectively. In addition,vecnronium and fentany were intermittent intravenously injected into patients to maintain the depth of anesthesia. HSP70 in blnod of patients were detected before anesthe- sia induction,1 h after the dura was opened and 24 h after the operation by ELISA method. Recovery, and tracheal extubation time of patients were recorded. Results HSP70 levels in blood of patients in the 2 groups were significantly increased compared with the former time point（P〈 0.05 ）. HSP70 content in propofol group was significantly higher at I h after the dura was opened （ （ 2.00 ± 0.24 ） ng/ml, （ 2.19 ± 0.26 ） ng/nd, t = 2. 080, P = 0. 047 ） and 24 h after the operation（ t = 2. 086, P= 0. 046 ） , and recovery and tracheal extubation time was shorter compared with the isoflureule group（P 〈0. 05）. Conclusion Perioperative moderate stress ,and early postoperative recovery and extubation can be maintained in patients with traumatic brain injury, with propofol anesthesia.
出处
《中华行为医学与脑科学杂志》
CAS
CSCD
北大核心
2011年第1期35-36,共2页
Chinese Journal of Behavioral Medicine and Brain Science
关键词
颅脑损伤
异丙酚
热休克蛋n
70
Traumatic brain injury
Propofol
Heat shoek protein 70
