对比丙泊酚与咪达唑仑应用于颅内脑膜瘤切除术患者对血流动力学、脑保护的影响

Effects of Propofol and Midazolam on Hemodynamics and Brain Protection in Patients under Excision of Intracranial Meningioma

对比分析丙泊酚与咪达唑仑应用于颅内脑膜瘤切除术患者对血流动力学、脑保护的影响。将2015年8月至2017年8月我院收治的行颅内脑膜瘤切除术患者86例,按数字随机表分为两组,每组43例。对照组采用咪达唑仑全麻诱导,观察组采用丙泊酚全麻诱导。对比两组全麻诱导前(T_1)、手术开始时(T_2)、切开脑膜即刻(T_3)、术毕(T_4)、术后1 h(T_5)的MAP、HR、Glu、Gly、GABA、ETI、SOD和MDA指标变化。观察组T_1、T_2、T_3、T_4、T_5时MAP、HR指标与对照组相比,差异无统计学意义(P>0.05)。观察组T_4、T_5时Glu、ETI指标低于对照组,GABA指标高于对照组,差异有统计学意义(P<0.05);观察组T_1、T_2、T_3、T_4、T_5时Gly指标与对照组相比,差异无统计学意义(P>0.05)。观察组T_4、T_5时SOD水平高于对照组,MDA水平低于对照组,差异有统计学意义(P<0.05)。咪达唑仑与丙泊酚全麻诱导应用于颅内脑膜瘤切除术患者对血流动力学指标均无明显影响,而丙泊酚全麻诱导可有效提高患者脑保护作用,值得推广。

This study is to compare the effects of propofol and midazolam on hemodynamics and brain protection in patients under excision of intracranial meningiomas.From August 2015 to August 2017,86 patients with intracranial meningiomas in our hospital were divided into two groups(n=43 in each group)by the random number table.Patients of the control group were induced by midazolam for general anesthesia,and those of the observation group were induced by propofol for general anesthesia.The indexes of MAP,HR,Glu,Gly,GABA,ETI,SOD and MDA were compared between the two groups before the induction of general anesthesia(T1),at the start of operation(T2),right at the incision of the meninges(T3),at the end of operation(T4)and 1 h(T5)after the operation.There were no significant differences of MAP and HR between the observation and control groups at T1,T2,T3,T4 and T5(P>0.05).Comparing with the control group,the levels of MDA,Glu and ETI in the observation group were lower while the levels of SOD and GABA were higher at T4 and T5(P<0.05);the Gly levels at T1,T2,T3,T4 and T5 in the observation group were significantly lower(P>0.05).The induction of midazolam or propofol in patients under excision of intracranial meningiomas has no significant difference on hemodynamics.Propofol induction of general anesthesia can effectively improve the effects of brain protection and is worth promoting.