右美托咪定對(duì)全麻下行腦血管瘤夾閉術(shù)患者腦功能的保護(hù)效果觀察

范軍朝??宋俊杰??卜一多??宋直雷??洪道先

[摘要]目的 分析右美托咪定對(duì)全麻下行腦血管瘤夾閉術(shù)患者腦功能的保護(hù)作用。 方法 將我院2013年3月～2015年3月收治的80例接受全麻下腦血管瘤夾閉術(shù)治療的患者隨機(jī)分為對(duì)照組與觀察組，各40例。觀察組靜脈給予右美托咪定作腦保護(hù)處理，對(duì)照組則給予生理鹽水，比較兩組患者腦功能的保護(hù)效果。 結(jié)果 麻醉后、手術(shù)開(kāi)始時(shí)、供瘤動(dòng)脈阻斷時(shí)、阻斷動(dòng)脈瘤時(shí)、恢復(fù)供瘤動(dòng)脈及術(shù)畢觀察組心率及平均動(dòng)脈壓的變化與對(duì)照組相比差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；術(shù)后12h及24h，觀察組血清NSE水平分別為（16.7±3.8）ng/mL、（23.5±4.5）ng/mL，均明顯低于對(duì)照組（P<0.05）。 結(jié)論 對(duì)全麻下行腦血管瘤夾閉術(shù)的顱內(nèi)動(dòng)脈瘤患者應(yīng)用右美托咪定方案，可穩(wěn)定患者循環(huán)系統(tǒng)及血流動(dòng)力學(xué)，有效保護(hù)患者腦組織，值得推廣。

[關(guān)鍵詞]腦血管瘤夾閉術(shù)；右美托咪定；腦保護(hù)

[中圖分類號(hào)] R651.1 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 2095-0616（2015）20-07-04

Observation on the protective effect of predetermine on brain function of patients with clipping of cerebral aneurysm under general anesthesia

FAN Junchao1 SONG Junjie1 BU Yiduo2 SONG Zhilei1 HONG Daoxian1

1. Department of Anesthesiology， the First Affiliated Hospital of Henan University， Kaifeng 475000， China； 2.The Fourth Military Medical University， Xi'an 610100， China

[Abstract] Objective To analyze the protective effect of predetermine on brain function of patients with clipping of cerebral aneurysm under general anesthesia. Methods 80 patients admitted into the hospital for clipping of cerebral aneurysm under general anesthesia from March 2013 to March 2015 and were randomly divided into the control group and the observation group of two groups with 40 cases in each. The observation group was given intravenous injection of predetermine for cerebral protection while the control group was given saline. The protective effects of brain function in the two groups were compared. Results After anesthesia， at the beginning of the operation， when tumor-supplied arteries were blocked， when aneurysm was blocked， when tumor-supplied arteries recovered and at the end of operation， the heart rate and changes of mean arterial pressure of the observation group， compared with the control group， the difference was statistically significant（P<0.05）； 12h and 24h after operation， serum NSE levels of the observation group respectively were （16.7±3.8）ng/mL and （23.5±4.5）ng/mL which were significantly lower than those of the control group（P<0.05）. Conclusion For anesthesia cerebral aneurysms clipping of contractile aneurysm patients given predetermine program， stable hydrodynamics in patients with circulatory system and effectively protect brain tissue of patients， should be promoted.

[Key words] Clipping of cerebral aneurysm； Predetermine； Brain protection

大量研究報(bào)道證實(shí)，顱內(nèi)動(dòng)脈瘤患者在接受腦血管瘤夾閉術(shù)后可能存在不同程度的腦功能障礙及腦組織損傷，對(duì)其術(shù)后恢復(fù)可能產(chǎn)生影響[1]。如何減輕腦血管瘤夾閉術(shù)后患者腦組織損傷程度，保護(hù)患者腦功能已成為當(dāng)前臨床研究者關(guān)注的重點(diǎn)課題[2]。基于此，為探討保護(hù)腦血管瘤夾閉術(shù)后患者腦功能的有效方案，我院對(duì)收治的80例患者展開(kāi)了對(duì)照分析，現(xiàn)報(bào)道如下。