丙泊酚注射液联合吸入用七氟烷用于颅内动脉瘤介入手术患者的临床研究

Clinical trial of propofol injection combined with sevoflurane inhalation in the treatment of patients with intracranial aneurysm undergoing interventional surgery

目的观察丙泊酚注射液联合吸入用七氟烷用于颅内动脉瘤介入手术患者的临床疗效及安全性。方法将120例颅内动脉瘤介入手术患者随机分为对照组和试验组,每组60例。对照组给予4.0μg·mL-1丙泊酚靶控输注进行麻醉维持;试验组给予2.0~4.0μg·mL-1丙泊酚靶控输注+1.5%~3.0%七氟烷持续吸入进行麻醉维持。比较2组患者的血清超氧化物歧化酶(SOD)、丙二醛(MDA)、平均动脉压(MAP)和心率(HR),以及药物不良反应的发生情况。结果与对照组相比,试验组术后即刻和术后12,24 h时的血清SOD水平均显著升高,MDA水平均显著降低;试验组在指令配合时、拔除气管插管时和出手术室时的MAP与HR均显著降低。试验组和对照组的躁动发生率分别为5.00%和20.00%,差异有统计学意义(P<0.05)。结论丙泊酚注射液联合吸入用七氟烷可以有效地改善颅内动脉瘤介入手术患者的氧化应激反应,稳定苏醒期血流动力学,且能降低躁动的发生率。

Objective To observe the clinical efficacy and safety of propofol injection combined with sevoflurane inhalation in the treatment of patients with intracranial aneurysm undergoing interventional surgery.Methods A total of 120 patients with intracranial aneurysm undergoing interventional surgery were randomly divided into control and treatment groups with 60 cases per group.Control group was given 4.0μg·mL-1 propofol target controlled infusion for anesthesia maintenance.Treatment group received 2.0-4.0μg·mL-1 propofol with target controlled infusion+1.5%-3.0%sevoflurane continuous inhalation for anesthesia maintenance.The levels of serum superoxide dismutase(SOD),malondialdehyde(MDA),mean arterial pressure(MAP),heart rate(HR),and adverse drug reactions were compared between two groups.Results At immediately after operation and 12,24 h after operation,the levels of SOD in treatment group were significantly higher than those in control group,and the levels of MDA were significantly lower than those in control group.At the time of command coordination,extubation of tracheal intubation and out of operating room,the levels of MAP and HR in treatment group were significantly lower than those of control group.The incidences of restlessness in treatment and control groups were 5.00%and 20.00%with significant difference(P<0.05).Conclusion Propofol injection combined with sevoflurane inhalation can improve oxidative stress response,stabilize hemodynamics during recovery and reduce the incidence of restlessness in the patients with intracranial aneurysm undergoing interventional surgery.