右美托咪定对全麻下行脑血管瘤夹闭术患者脑功能的保护效果观察

范军朝??宋俊杰??卜一多??宋直雷??洪道先

[摘要]目的 分析右美托咪定对全麻下行脑血管瘤夹闭术患者脑功能的保护作用。 方法 将我院2013年3月～2015年3月收治的80例接受全麻下脑血管瘤夹闭术治疗的患者随机分为对照组与观察组，各40例。观察组静脉给予右美托咪定作脑保护处理，对照组则给予生理盐水，比较两组患者脑功能的保护效果。 结果 麻醉后、手术开始时、供瘤动脉阻断时、阻断动脉瘤时、恢复供瘤动脉及术毕观察组心率及平均动脉压的变化与对照组相比差异有统计学意义（P<0.05）；术后12h及24h，观察组血清NSE水平分别为（16.7±3.8）ng/mL、（23.5±4.5）ng/mL，均明显低于对照组（P<0.05）。 结论 对全麻下行脑血管瘤夹闭术的颅内动脉瘤患者应用右美托咪定方案，可稳定患者循环系统及血流动力学，有效保护患者脑组织，值得推广。

[关键词]脑血管瘤夹闭术；右美托咪定；脑保护

[中图分类号] R651.1 [文献标识码] A [文章编号] 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

大量研究报道证实，颅内动脉瘤患者在接受脑血管瘤夹闭术后可能存在不同程度的脑功能障碍及脑组织损伤，对其术后恢复可能产生影响[1]。如何减轻脑血管瘤夹闭术后患者脑组织损伤程度，保护患者脑功能已成为当前临床研究者关注的重点课题[2]。基于此，为探讨保护脑血管瘤夹闭术后患者脑功能的有效方案，我院对收治的80例患者展开了对照分析，现报道如下。