丙泊酚对急性重型颅脑损伤患者的脑保护作用及机制探讨

Cerebral Protective Effect and Mechanism of Propofol for Treating Acute Severe Brain Injury

目的观察丙泊酚对急性重型颅脑损伤患者的脑保护作用。方法选择2014年7月至2015年4月医院收治的急性重型颅脑损伤患者80例,均采用静吸复合全身麻醉下手术治疗,采用双盲法随机分为对照组(A组)及丙泊酚组(B组),各40例。A组患者采用靶控输注瑞芬太尼0.1~0.2μg/kg,B组患者采用靶控输注瑞芬太尼0.1~0.2μg/kg及丙泊酚2 mg/(kg·h)。观察患者入室前及术后24 h2个时间点的肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超氧化物歧化酶(SOD)水平及术后的死亡率和致残率。结果治疗后,与A组比较,B组患者术后24 h的TNF-α,IL-6及SOD水平均明显降低(P<0.05),患者的死亡率及致残率均明显降低(P<0.05)。结论丙泊酚对急性重型颅脑损伤患者有脑保护作用,且可降低患者术后的死亡率及致残率。

Objective To observe the cerebral protective effect and mechanism of propofol on the patients with acute severe craniocerebral injury.Methods 80 patients with acute severe craniocerebral injury selected from July 2014 to April 2015 in the hospital,the patients were given surgical treatment undergoing intravenous inhalation combined with general anesthesia,the patients were randomly divided into the control group( group A) and the propofol group( group B) by double blind method,40 cases in each group.The group A were treated with target controlled infusion of 0.1- 0.2 g / kg fentanyl,the group B were treated with target controlled infusion of remifentanil0.1- 0.2 g / kg and propofol 2 mg /( kg·h); the TNF- α,IL- 6,SOD level,morbidity and mortality in the two groups were observed before and after operation 24 h.Results After operation,compared with the group A,the TNF- α,IL- 6 and SOD level in the group B were significantly decreased( P < 0.05),the mortality and disability rate were significantly decreased( P < 0.05).Conclusion Propofol for treating acute severe craniocerebral injury has cerebral protective effect,and can reduce the postoperative mortality and disability rate.