丙泊酚联合芬太尼在重型颅脑损伤并脑疝形成患者急症手术中的麻醉效果

Anesthetic effect of propofol combined with fentanyl in the emergency surgery of patients with severe traumatic brain injury and brain herniation

目的探究芬太尼联合丙泊酚在重型颅脑损伤并脑疝形成患者急症手术中的麻醉效果。方法选择2010年2月～2011年2月本院收治的30例重型颅脑损伤并脑疝形成患者作为观察组,给予芬太尼+丙泊酚联合麻醉处理;选取同期收治同症患者20例作为对照组,给予异氟醚维持麻醉。结果两组无死亡病例,无明显不良反应。两组围术期血液流变学(HR)无明显变化;两组术中血糖均有所升高,术后恢复正常,但对照组升高较为明显,差异具有统计学意义(P<0.05)。观察组术中舒张压(DBP)、收缩压(SBP)较对照组平稳,差异有统计学意义(P<0.05)。结论芬太尼联合丙泊酚麻醉诱导时间快,且术后无明显不良反应,有助于保护患者脑组织,提高急症手术围术期安全性,值得临床应用与推广。

Objective To discuss the anesthetic effect of propofol combined with fentany in the emergency surgery of patients with severe traumatic brain injury and brain herniation. Methods Thirty patients with severe craniocerebral injury and cerebral herniation in our hospital from February 2010 to February 2011 were selected as the observation group, who were given fentanyl and propofol combined anesthesia; 20 paitents with same illness were selected as control group in the same time, who were given isoflurane anesthesia. Results There were no one dead and no obvious adverse reaction in two groups. The perioperative period of blood rheology （HR） of two groups had no obvious changes. Blood glucose of two groups were increased, which back to normal after operation, but blood glucose in control group increased obviously, the difference was significant （P 0.05）. Diastolic blood pressure （DBP）, systolic blood pressure （SBP） of observation group were more stable than those of control group, the differences were significant （P 0.05）. Conclusion Fentanyl combined with propofol for induction of anesthesia is short, and there is no obvious adverse reaction after operation, which can help to protect the brain tissue of patients with acute perioperative period, improve safety, worthy of clinical application and popularization.