右美托咪定复合丙泊酚对脑胶质瘤切除术中脑组织损伤的影响

Effect of dexmedetomidine combined with propofol on brain tissue damage in brain glioma resection

目的:研究右美托咪定(Dex)复合丙泊酚对脑胶质瘤切除术中脑组织损伤的影响。方法:选择2014年5月~2016年12月期间在我院接受胶质瘤切除术的74例患者,随机分为Dex组和对照组,分别在诱导前给予右美托咪定干预和生理盐水干预。麻醉前(T0)、切开硬脑膜时(T1)、苏醒后即刻(T2)、术后24h(T3)时,测定血清中脑组织损伤标志物、PI3K/AKT/iNOS、氧化反应分子的含量以及脑氧代谢指标的水平。结果:两组患者T2、T3时血清中神经元特异性烯醇化酶(NSE)、S100蛋白(S100B)、髓鞘碱性蛋白(MBP)、胶质纤维酸性蛋白(GFAP)、PI3K、AKT、诱导型一氧化氮合酶(iNOS)、丙二醛(MDA)的含量以及颈内动脉与颈内静脉含氧量的差值(AVDO_2)、脑组织氧摄取率(CERO_2)的水平均显著高于T0、T1,血清中超氧化物歧化酶(SOD)、CAT的含量以及颈静脉球部血氧饱和度(SjvO_2)的水平均显著低于T0、T1,且Dex组患者T2、T3时血清中NSE、S100B、MBP、GFAP、PI3K、AKT、iNOS、MDA的含量以及AVDO_2、CERO_2的水平均显著低于对照组,血清中SOD、CAT的含量以及SjvO_2的水平均显著高于对照组(P<0.05)。结论:右美托咪定复合丙泊酚能够减轻脑胶质瘤切除术中的脑组织损伤程度。

Objective：To study the effect of dexmedetomidine combined with propofol on brain tissue damage in brain glioma resection.Methods：A total of 74 patients who received brain glioma resection in our hospital between May 2014 and December 2016 were selected and randomly divided into Dex group and control group.Before induction,patients in Dex group and control group received dexmedetomidine intervention and saline intervention respectively.Before anesthesia（T0）,at dura mater incision（T1）,at the moment of recovery（T2）and 24 hours after operation（T3）,serum brain tissue damage marker,PI3K/AKT/iNOS and oxidation reaction molecule contents as well as cerebral oxygen metabolism index levels were determined.Results：Serum NSE,S100 B,MBP,GFAP,PI3 K,AKT,iNOS and MDA contents as well as AVDO2 and CERO2 levels of both groups at T2 and T3were significantly higher than those at T0 and T1（P〈0.05）while serum SOD and CAT contents as well as SjvO2 levels were significantly lower than those at T0 and T1（P〈0.05）,and serum NSE,S100 B,MBP,GFAP,PI3 K,AKT,iNOS and MDA contents as well as AVDO2 and CERO2 levels of Dex group at T2 and T3were significantly lower than those of control group（P〈0.05）while serum SOD and CAT contents as well as SjvO2 levels were significantly higher than those of control group（P〈0.05）.Conclusions：Dexmedetomidine combined with propofol can reduce brain tissue damage in brain glioma resection.