不同麻醉方法对颅脑外伤手术患者脑血管自身调节功能的影响

The effect on cerebral vascular function in patients with craniocerebral trauma operation bydifferent anesthesia methods

目的探究不同麻醉方法对颅脑外伤手术患者脑血管自身调节功能的影响。方法分析2013年1月~2014年12月在我院收治的84例急诊颅脑外伤患者的临床资料,观察组（43例）采用丙泊酚静脉注射麻醉,对照组（41例）采用七氟烷进行吸入麻醉。结果两组研究对象气管插管时、开颅时、缝皮时MAP、HR与麻醉诱导前相比呈现下降趋势,观察组患者气管插管时、开颅时、缝皮时MAP、HR明显低于对照组,差异具有统计学意义（P〈0.05）;观察组患者气管插管时、开颅时、缝皮时Vm与麻醉诱导前水平相比呈现下降趋势,且插管时、开颅时、缝皮时Vm明显低于对照组,差异具有统计学意义（P〈0.05）,对照组患者不同麻醉时程Vm不存在统计学差异（P〉0.05）。观察组患者PI与麻醉诱导前相比明显升高,对照组患者PI与麻醉诱导前相比呈现降低趋势,观察组患者气管插管时、开颅时、缝皮时PI水平明显高于对照组,差异具有统计学意义（P〈0.05）;观察组患者麻醉诱导前（t=2.396,P=0.019）、气管插管时（t=2.568,P=0.012）、开颅时（t=15.86,P〈0.001）、缝皮时（t=12.75,P〈0.001）THRR水平明显高于对照组,差异具有统计学差异（P〈0.05）。结论静脉麻醉可以有效提高脑血管自身调节功能,降低脑血流速,增加外周阻力,对于CA功能调节强于吸入麻醉,在颅脑外伤手术麻醉方式的选择上具有良好的临床指导意义。

Objective To investigate The effect on cerebral vascular function in patients with craniocerebral trauma operation bydifferent anesthesia methods.Methods To analyze the clinical data of 84 patients with traumatic brain injury in our hospital from January 2013 to December,the observation group（43cases）were treated with propofol intravenous anesthesia,while the control group（41cases）was treated with seven sevoflurane inhalation anesthesia.Results In the two group,MAP and HR in Tube intubation,craniotomy,and Suture of skin were decreased compared with the induction of anesthesia,In the observation group,the HR and MAP in Tube intubation,craniotomy,and Suture of skin were significantly lower than those in the control group,and the difference was statistically significant（P0.05）;In the observation group,the Vm of patients with Tube intubation,craniotomy,and Suture of skin,and the level of and the level of anesthesia were decreased compared with that before anesthesia induction,the Vm in Tube intubation,craniotomy,and Suture of skin were significantly lower than those of the control group,and the difference was statistically significant（P0.05）.The PI of the observation group was significantly higher than that before anesthesia induction,and PI of the control group was decreased compared with the induction of anesthesia,The PI level in the observation group in induction of anesthesia,tube intubation,craniotomy,and Suture of skin was significantly higher than that in the control group,the difference was statistically significant（P0.05）;The levels of THRR in induction of anesthesia（t=2.396,P=0.019）,tube intubation（t=2.568,P=0.012）,craniotomy（t=15.86,P0.001）,and Suture of skin（t=12.75,P0.001）of the observation group were significantly higher than those in the control group（P0.05）.Conclusion The intravenous anesthesia can effectively improve the cerebral blood vessel＇s self-adjustment function,reduce the cerebral blood flow velocity,increase the peripheral resistance,and the CA function is better than the inhalation anesthesia,and it has a good clinical significance in the choice of anesthesia method.