静吸复合麻醉与全凭静脉麻醉在重症颅脑外伤开颅探查术+血肿清除术中的运用对比

Comparison of Application of Combined Intravenous Anesthesia and Total Intravenous Anesthesia in Craniotomy Exploration and Hematoma Removal for Severe Craniocerebral Trauma

目的对比静吸复合麻醉与全凭静脉麻醉在重症颅脑外伤开颅探查术+血肿清除术中的运用效果。方法简单随机选取2022年4月—2023年4月福建省漳平市医院实施开颅探查术+血肿清除术治疗的50例重症颅脑外伤患者作为研究对象,按随机数表法分为研究组和对照组,每组25例。对照组患者采用全凭静脉麻醉,研究组采用静吸复合麻醉。对比两组患者不同时间点血流动力学指标、术后恢复以及麻醉不良反应情况。结果研究组自主呼吸恢复、拔管及苏醒时间依次为(6.17±1.29)、(10.22±2.18)、(6.06±1.08)min,均短于对照组的(8.55±1.41)、(15.25±3.03)、(10.12±1.98)min,差异有统计学意义(t=6.227、6.738、20.373,P均<0.05);两组颅脑外伤者麻醉前平均动脉压、心率水平相比,差异无统计学意义(P均>0.05)。切皮时,两组颅脑外伤者的平均动脉压、心率体征指标与麻醉前相比明显改善,且研究组平均动脉压、心率水平均优于对照组,差异有统计学意义(P均<0.05)。两组颅脑外伤者在切硬脑膜时、术后12 h的平均动脉压、心率体征指标水平与切皮时相比均明显改善,且研究组优于对照组,差异有统计学意义(P均<0.05);研究组的不良反应发生率(4.00%)低于对照组(24.00%),差异有统计学意义(χ^(2)=4.153,P<0.05)。结论静吸复合麻醉在重症颅脑外伤开颅探查术+血肿清除术中的效果优于全凭静脉麻醉。

Objective To compare the effect of combined anesthesia with intravenous anesthesia in craniotomy exploration and hematoma removal for severe craniocerebral trauma.Methods A total of 50 patients with severe craniocerebral trauma who underwent exploratory craniotomy and hematoma removal in Zhangping Hospital of Fujian Province from April 2022 to April 2023 were simple and randomly selected as the study objects,and they were divided into the study group and the control group according to a random number table method,with 25 cases in each group.The control group was given intravenous anesthesia,and the study group was given intravenous combined anesthesia.Hemodynamic indexes,postoperative recovery and anesthesia adverse reactions were compared between the two groups at different time points.Results The time of spontaneous respiratory recovery,extubation and resuscitation in the study group was(6.17±1.29)min,(10.22±2.18)min and(6.06±1.08)min,which were shorter than(8.55±1.41)min,(15.25±3.03)min and(10.12±1.98)min in the control group,and the differences were statistically significant(t=6.227,6.738,20.373,all P<0.05).There were no significant differences in mean arterial pressure and heart rate before anesthesia between the two groups(both P>0.05).At the time point of incision,the mean arterial pressure and heart rate of the two groups were significantly improved than those before anesthesia,and the mean arterial pressure and heart rate of the study group were better than those of the control group,and the differences were statistically significant(both P<0.05).The mean arterial pressure and heart rate indicators of the two groups at the time of dural incision and 12 h after surgery were significantly improved than those at the time of skin incision,and the study group were better than those in the control group,and the differences were statistically significant(both P<0.05).The incidence of adverse reactions in study group(4.00%)was lower than that in control group(24.00%),and the difference was statistically significant(χ^(2)=4.153,P<0.05).Conclusion The effect of intravenous anesthesia combined with intravenous anesthesia in the operation of craniotomy exploration and hematoma removal for severe craniocerebral trauma is better than that of intravenous anesthesia.