不同麻醉维持方法对颅内动脉瘤夹闭术患者应激水平的影响

Effects of Different Anesthetic Maintenance on Stress Hormone Level during Operation of Intracranial Aneurysm Clipping

目的探讨颅内动脉瘤夹闭术中不同麻醉维持方法对应激水平的影响。方法选择颅内动瘤夹闭术患者30例,随机分为两组,以舒芬太尼为主的麻醉维持组(n=15,S组)、以丙泊酚为主的麻醉维持组=15,P组)。于切皮前(T1)、切皮后(T2)、动脉瘤夹闭后(T3)、术毕(T4)4个时间点取动脉血测血糖(GLU)、甲肾上腺素(NE)浓度并记录心率(HR)、平均动脉压(MAP)。结果组内比较:与T1比较,两组GLU于T3,升高(P<0.05),NE于T2,T3,T4升高(P<0.05),HR于T2升高,T3,T4降低(P<0.05),两组MAP于T2升高T3,T4降低(P<0.05)。组间比较:与P组比较,S组GLU于T3,T4较低(P<0.05),NE于T3,T4较低(P<05),HR于T3,T4较低(P<0.05),S组MAP无统计学意义。结论以舒芬太尼为主的麻醉维持方法更能抑应激反应。

Objective To investigate the effects of different anesthetic maintenance on stress hormone level during operation of intracranial aneurysm clipping .Methods Thirty adult patients scheduled for intracranial aneurysm clipping ,according to different anesthetic maintenance,were randomly divided into two groups（n=15）：Groups S and Groups P.Group S was mainly given sufentanil,while group P was mainly given propofol .The arterial blood was extracted to detect the concentration of GLU and NE before operation （ T1 ） , after cutting scalp（T2）,after aneurysm clipping（T3）,after operation（T4）.Meanwhile,record the HR and MAP.Results Comparison within-group：com-pared with T1,GLU in both groups was elevated at T3 and T4（P〈0.05）;NE in both groups was elevated at T2,T3 and T4（P〈0.05）;HR in both groups was elevated at T2,while reduced at T3 and T4（P〈0.05）;MAP in both groups was elevated at T2,while reduced at T3 and T4（P〈0.05）.Comparison between-groups：Compared with group P at the corresponding point ,GLU in group S was lower at T3 and T4（P〈0.05）;NE in group S was lower at T3 and T4（P〈0.05）;HR in group S was lower at T3 and T4（P〈0.05）;There was no difference be-tween the two groups .Conclusion The anesthetic maintenance mainly given sufentanil could inhibite stress hormone level better .