全麻诱导无通气期时限对颅内压的影响

The effects of infracranial pressure in no-breathing period by general marcosis induction

目的观察无通气时间对颅内压 (ICP)的影响 ,以探讨颅脑肿瘤患者适宜的无通气时限。方法 16例颅脑肿瘤手术患者经腰段蛛网膜下腔穿刺置管后接压力换能器测蛛网膜下腔脑脊液压力 (SCFP) ,全麻插管后维持足够的麻醉深度 ,控制呼吸并通过调控使病人ICP、ETCO2 接近插管前水平 ,此时在不接麻醉机停止通气的状态下分别记录无通气期 30、6 0、90、12 0秒时的ICP值。结果无通气期 30秒时ICP变化不明显 (P >0 .0 5 ) ,而 6 0秒以后ICP则显著升高 (P <0 0 1)。结论对颅脑肿瘤患者 ,特别是出现高颅压危象者麻醉诱导无通气期应尽量缩短 ,最好控制在 30秒以内 ;适当地给予过度通气 ,是降低颅内压的有效方法。

Objective In order to explore the proper no breathing period for craniocerebral tumor patients that the effects of intracranial pressure (ICP) in no breathing period were observed.Methods 16 cerebrospinal pressure. All the patients were in tubated and adjusted anesthetic deep to the level of pre intubation. The ICP was measured after 30,60,90,120 sec in no breathing period respectively.Results The ICP was not significant difference during 30sec of no breathing period( P >0.05), howere, it was increased significantly after 60sec ( P <0.01).Conclusion The most suitable no breathing period was 30sec. The period shoule be as shorter as possible to reduce intracranial hyperfension of patients. Overventilafion was an effective method to decrease Icp.