摘要
目的：探讨异丙酚预处理对腹腔镜手术老年患者血清神经元特异性烯醇化酶（NSE）和S100β蛋白浓度的影响。方法：选取行腹腔镜胃肠手术的老年患者60例,随机均分为异丙酚预先处理组（S1组）、异丙酚预先处理组（S2组）和观察组（C组）各20例。观察组两组入室后分别泵注异丙酚6 mg/（kg·h）和异丙酚10mg/（kg·h）,30min后停止泵注,建立气腹;C组不泵注异丙酚维持。分别于气腹建立前（H1）、气腹建立后1h（H2）、气腹解除即刻（H3）和气腹解除后1h（H4）采取静脉血,同时在4个时点分别经桡动脉和颈内静脉球部采血0.5mL（肝素抗凝并隔绝空气）即刻进行动、静脉血气分析、血糖、血乳酸、血清NSE、S100β蛋白浓度测定。结果：H2~H4时两组患者血清NSE和S100β蛋白浓度均明显高于H1时（P〈0.05）;H3时两组患者血清NSE和S100β蛋白浓度和H4时血清NSE浓度均明显高于H2时（P〈0.05）;H4时两组患者血清NSE和S100β蛋白浓度均明显低于H3时（P〈0.05）;不同时点两组组间血清NSE和S100β蛋白浓度差异均无统计学意义（P〉0.05）。结论：气腹建立后会对腹腔镜手术老年患者产生一定程度的脑损伤,不同剂量的异丙酚预先泵注30min对此种脑损伤无明显影响。
Objective： To investigate the influence of propofol pretreatment laparoscopic surgery in elderly patients with serum neuron--specific enolase （NSE） and S10013 protein concentration. Methods： elective laparoscopic gastrointestinal surgery in elderly patients in 60 cases were randomly divided into the treatment group prior propofol （S1 group）, the propofol pre-- treated group （S2 group） and the observation group （group C） of the 20 cases. Two groups were observed after inhalation of propofol burglary 6 mg / （kg·h）and propofol 10 mg / （kg ~ h）, 30 min after discontinuation of inhaled establish pneumoper- itoneum~ group C without infusion of propofol maintained. Respectively before （H1） pneumoperitoneum is established, after the establishment of pneumoperitoneum 1 h （H2）, the immediate lifting of pneumoperitoneum （H3） after abdominal gas lift lh （H4） take blood, while the four time points, respectively, via the radial artery and jugular intravenous bulb blood 0.5ml （heparin and cut off the air） were fixed immediately measured blood gas analysis, blood glucose, blood lactate, serum NSE,S100β protein concentration. Conclusion： After establishing pneumoperitoneum laparoscopic surgery in elderly patients, they will have some degree of brain damage, propofol, or 1% sevoflurane inhalation 30min advance with no significant effect on such brain damage.
出处
《海南医学院学报》
CAS
2015年第8期1069-1071,1075,共4页
Journal of Hainan Medical University
基金
2014年湛江市非资助科技攻关项目(2014B01008)~~
