摘要
目的:观察尼卡地平控制性降压对经蝶垂体瘤切除术患者术中脑氧饱和度(cerebral regionaloxygen saturation)的影响。方法:择期经蝶垂体瘤切除术患者40例,ASA 1～2级,随机分为两组:尼卡地平降压组(n=20)和非降压组(n=20)。非降压组术中吸入七氟醚维持麻醉,降压组术中行尼卡地平控制性降压,平均动脉压下降幅度30%～40%,切除垂体瘤后停止尼卡地平泵入,终止降压。分别于诱导前(T0)、手术开始时(降压前,T1)、降压开始后10 min(T2),20 min(T3)及30 min(T4)、垂体瘤切除后即刻(T5)、停止降压后10 min(T6),20 min(T7)及30 min(T8)(非降压组于相应时间)测定并记录脑氧饱和度(rSO2%)。于术后4 h,第1,3,7天随访患者,记录有无术后神经系统并发症,如偏瘫、失语及精神障碍等。结果:(1)降压开始后30 min平均动脉压由诱导前的(95±11)mmHg降至(62±6)mmHg,停止降压后30 min血压回升至(76±8)mmHg。(2)降压组降压期间(T2至T5)脑氧饱和度明显低于非降压组对应时刻的数值。(3)术后随访两组均未出现明确神经系统并发症。结论:在经蝶垂体瘤切除术中进行控制性降压会降低脑氧饱和度,但未发现术后神经系统并发症发生率的增加。
Objective：To investigate the effect of controlled hypotension induced of nicardipine on cerebral regional oxygen saturation（rSO2%） during transsphenoidal pituitary tumor resection.Methods： Forty patients with ASA I—Ⅱ were randomly divided into two groups： nicardipine group（Group A,n=20） and control group（Group B,n=20）.Patients in Group B were treated by sevoflurane to maintain anesthesia,while patients in Group A were treated by controlled hypotension with nicardipine.The mean arterial blood pressure（MAP） decreased by 30%-40%.Hypotension was terminated after resection.rSO2% was recored before induction（T0）,when the surgery begined（before hypotension,T1）,10 min,20 min and 30 min after hypotension（T2,T3,T4）,after resection（T5）,10 min,20 min,and 30 min after termination of hypotension（T6,T7,and T8）.All patients were followed up at 4h,1 day,3 days,and 7 days after the operation,to investigate the occurrence of central nervous system complications such as hemiplegia,aphasia and mental disorder.Results： MAP was decreased from（95±11） mmHg to（62±6） mmHg 30 min after hypotension,and restored to（76±8） mmHg 30 min after resection.In group A,the values of rSO2% was significantly lower than that of Group B during hypotension period（T2-T5）.Results of follow-up showed no central nervous system complications.Conclusions： Controlled hypotension by nicardipine can reduce rSO2% during transsphenoidal pituitary tumor resection,and it has no central nervous system complications.
出处
《海南医学院学报》
CAS
2011年第7期988-990,993,共4页
Journal of Hainan Medical University
基金
海南医学院科研基金资助学报项目(0020110254)~~
关键词
尼卡地平
垂体瘤
脑氧饱和度
控制性降压
外科手术
Nicardipine； Pituitary tumor； Cerebral regional oxygen saturation； Controlled hypotension； Surgery；
