瑞芬太尼对重型颅脑损伤围术期S100B蛋白含量的影响

Effect of the remifentanil for severe head injury perioperative S100B protein content

目的探讨瑞芬太尼对重型颅脑损伤围术期S100B蛋白含量的影响,以期为合理使用瑞芬太尼提供依据。方法本组64例患者随即机分为瑞芬太尼组和芬太尼组分别进行麻醉,记录术前、手术开始2h、手术结束时的SBp、DBp和HR,同时取静脉血测定血清S100B含量。结果芬太尼组患者的血流动力变化有显著差异性,手术开始2h与术前比较,血压、心率均明显降低(P<0.05);瑞芬太尼组患者在围手术期的血压、心率变化幅度小(P>0.05)。瑞芬太尼与芬太尼组在手术开始2h的血压、心率均有显著的统计学差异(P<0.05)。术前两组S100B蛋白含量差异无统计学意义(P>0.05),但手术开始2h时和手术结束时,瑞芬太尼组S100B蛋白含量显著低于芬太尼组(P<0.05);两组术前、手术2h、手术结束时S100B蛋白的含量均呈持续升高过程。结论瑞芬太尼可减少脑损伤,是神经外科静脉麻醉较为理想的药物。

Objective To approach the effect of Remifentanil for severe head injury Perioperative S100B protein content, in order to provide a reasonable basis for the use of remifentanil. Methods 64 cases of patients were randomly divided into Remifentanil group and fentanyl group for anesthetizing,record the SBP, DBP and HR before operation,at the beginning two hours of operation,at the end of the operation,at the same time,collected the venous blood and checked the content of blood serum S100B. Results the hemodynamic changes of fentanyl group appeared significant deviation,comparing of the beginning two hours of operation and pre-operative, the blood pressure, heart rate were significantly reduced （P〈0.05）;Remifentanil patients in the perioperative, the blood pressure, heart rate changes in the range of small （P 〉 0.05）. In Remifentanil group and fentanyl group,the blood pressure,heart rate had statistically significant differences （P 〈 0.05） at the beginning two hours of operation. There were no statistically significant differences （P 〉 0. 05） in the content of S100B protein before operation. But at the beginning two hours of operation and at the end of the operation, the content of S100B protein in Remifentanil group were significantly lower than the fentanyl group＇s （P 〈 0.05）. The content of S100B protein in the two groups were elevated the process of continuous before operation,at the beginning two hours of operation, at the end of the operation. Conclusions Remifentanil can reduce the damage of brain,it is the ideal intravenous anesthesia drugs in neurosurgery.