摘要
目的探讨羟乙基淀粉注射液对颅脑手术患者颅内压及脑氧合的影响。方法将60例行颅脑手术的患者随机分为试验组和对照组,每组各30例。麻醉完成待血流动力学指标平稳后,试验组患者静脉滴注羟乙基淀粉注射液(4 ml/kg),对照组患者静脉滴注20%甘露醇(1 g/kg)。分别监测给药前及给药后30、60、120分钟两组患者平均动脉压(mean arterial pressure,MAP)和脑脊液压(cerebrospinal fluid pressure,CSFP),计算脑灌注压(cerebral perfusion pressure,CPP),记录尿量。采集两组患者桡动脉及颈内静脉血行血气分析,记录给药前及给药后30、60、120分钟时颈内静脉血氧饱和度(jugular venous oxygen saturation,Sjv O2)、脑动静脉血氧含量差(Da-jv O2)及脑氧摄取率(cerebral extraction rate of oxygen,CERO2)。结果与给药前比较,两组患者给药后各时间点MAP、CPP均明显升高(P<0.05),CSFP明显降低(P<0.05)。给药后30分钟,试验组患者CSFP明显低于对照组(P<0.05);给药后60分钟,试验组患者MAP、CPP明显高于对照组(P<0.05)。试验组患者各时间点尿量均明显少于对照组(P<0.05)。两组患者给药后各时间点Sjv O2均明显增加(P<0.05),而Da-jv O2、CERO2均明显降低(P<0.05)。结论羟乙基淀粉注射液可明显降低颅脑手术患者颅内压,改善脑氧代谢。
ObjectiveTo explore the effect of hydroxyethyl starch on intracranial pressure and cerebral oxygenation of patients underwent craniocerebral operations.Method60 patients underwent craniocerebral operations were randomly divided into experimental group and control group, 30 cases in each group. Hydroxyethyl starch （4 ml/kg） was given to experimental group after anesthesia under the condition of stable hemodynamic index, while 20% mannitol （1 g/kg） was given to control group. Mean arterial pressure （MAP） and cerebrospinal lfuid pressure （CSFP） of two groups were detected before and 30, 60 and 120 minutes after administration, cerebral perfusion pressure （CPP） and urine volume were also recorded. Blood from radial artery and jugular vein were collected to make blood-gas analysis, jugular venous oxygen saturation （SjvO2）, cerebral artery-vein blood oxygen content difference （Da-jvO2） and cerebral extraction rate of oxygen （CERO2） were recorded before and 30, 60 and 120 minutes after administration.ResultCompared with before administration, MAP and CPP of the two groups at each time point increased evidently after administration, while CSFP decreased remarkably, with signiifcant differences （P〈0.05）. 30 minutes after administration, CSFP of experimental group was obviously lower than control group （P〈0.05）; 60 minutes after administration, MAP and CPP of experimental group were higher than control group （P〈0.05）. Urine volume of experimental group was apparently lower than control group （P〈0.05）. Additionally, SjvO2 increased while Da-jvO2 and CERO2 decreased signiifcantly after administration at each time point （P〈0.05）.Conclusion Hydroxyethyl starch can remarkably reduce intracranial pressure and improve cerebral oxygen metabolism of patients underwent craniocerebral operations.
出处
《中国医学前沿杂志（电子版）》
2015年第9期80-83,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
羟乙基淀粉
颅内压
脑氧合
Hydroxyethyl starch
Intracranial pressure
Cerebral oxygenation
