瑞芬太尼对重型颅脑损伤患者脑氧代谢改善作用

The Improvement Role of Remifentanil on the Brain Oxygen Metabolism in Patients with Severe Traumatic Brain Injury

目的探讨瑞芬太尼对重型颅脑损伤患者脑氧代谢改善作用.方法选取2011年12月至2013年9月期间云南省西双版纳州人民医院收治的重型颅脑损伤患者84例为研究对象,对患者的临床指标进行回顾性分析.结果 (1)比较2组入选对象麻醉前的各项氧代谢指标,数据比较差异无显著统计学意义;比较2组入选对象麻醉后10 min的氧代谢指标水平,治疗组的CERO2显著高于对照组,治疗组的Cjv O2和Da-jv O2显著低于对照组,且数据比较差异有统计学意义(P<0.05);(2)比较2组入选对象麻醉前的各项血动力指标,数据比较差异无显著统计学意义;比较2组入选对象麻醉后10 min的血动力指标水平,治疗组的Qmean和Wv显著高于对照组,治疗组的DR显著低于对照组,且数据比较差异均具有统计学意义(P<0.05).结论在临床针对重型颅脑损伤患者实施麻醉的实践过程中,采用瑞芬太尼的临床整体效果较好,对重型颅脑损伤患者脑氧代谢改善作用明显,是临床实践过程中理想选择方式之一.

Objective To investigate the improvement role of remifentanil on the brain oxygen metabolism in patients with severe traumatic brain injury. Methods 84 cases of patients with severe brain injury from December 2010 to December 2011 in our hospital were chosen. The clinical parameters were compared retrospectively. Results （1） The indexes of patients before anesthesia were compared, the difference showed no statistically significance. The oxygen metabolism levels of the two groups 10 minutes after anesthesia, the CERO2 in the treatment group was significantly higher than that of the control group, the CjvO2 andDa-jv02 in the treatment group were significantly lower than those of the control group, and the differences had statistical significance （P〈0.05） ; （2） The indicators of the blood power of the two groups before anesthesia showed no statistically significant difference. The indicators of the blood power of the two groups 10 rain after anesthesia, the Q mean and Wv in the treatment group were significantly higher than those of the control group, and the DR in the treatment group was significantly lower than that of the control group, and the differences between the two groups were statistically significant （P 〈0.05）. Conclusionsln clinical practice for patients with severe traumatic brain injury in anesthesia, the overall effect of clinical remifentanil is better, and it can improve cerebral oxygen metabolism in patients with severe traumatic brain injury, and it is the ideal choice for clinical practice.