期刊文献+

异丙酚对亲体肝脏移植患儿脑损伤的影响 被引量:4

The effect of propofol on brain during pediatric parent liver transplantation
下载PDF
导出
摘要 目的评价异丙酚对亲体肝脏移植患儿脑损伤的影响。方法选择天津市第一中心医院40例因先天性胆道闭锁择期行亲体肝脏移植的患儿,性别不限,年龄6~9个月,体重6.0~9.5 kg,ASAⅢ或Ⅳ级,采用随机数字表法将其分为2组(n=20):异丙酚组(P组)和对照组(C组)。入室后开放静脉通路,静脉注射阿托品0.01 mg/kg,咪达唑仑0.10~0.15 mg/kg,依托咪酯0.2~0.3 mg/kg,芬太尼2~5μg/kg和维库溴铵0.8~1.0 mg/kg。麻醉诱导后气管插管,行机械通气,P组持续泵注异丙酚9~15 mg/(kg·h)至术毕,C组持续吸入1%~2%七氟烷至术毕。分别于切皮即刻(T0)、无肝期30分钟(T1)、新肝期3小时(T2)、新肝期24小时(T3)时取中心静脉血,检测血清星形胶质源性蛋白(S100-β)和神经元特异性烯醇化酶(NSE)。结果两组患儿基本情况(年龄、体重、无肝期、麻醉时间、手术时间、输血量、尿量)无显著差异(P>0.05)。两组患儿T1、T2时间点的S100-β和NSE水平均比T0时有所升高〔C组,S100-β(ng/ml):11.29±3.45、8.66±1.57比5.26±0.94,P<0.05,NSE(ng/ml):26.92±4.43、24.57±4.12比20.68±2.94,P<0.05;P组:S100-β(ng/ml):9.28±1.85、6.47±0.86比4.91±1.25,P<0.05,NSE(ng/ml):24.50±3.26、22.23±3.07比19.89±4.40,P<0.05〕;与C组比较,P组T1~T3时间点S100-β和NSE水平均下降,并且差异具有统计学意义〔S100-β(ng/ml):9.28±1.85比11.29±3.45、6.47±0.86比8.66±1.57、5.49±0.79比6.36±1.42,P<0.05;NSE(ng/ml):24.50±3.26比26.92±4.43、22.23±3.07比24.57±4.12、20.04±20.71比21.94±3.07,P<0.05〕。结论异丙酚可减轻亲体肝脏移植患儿的脑损伤程度。 Objective To evaluate the effects of propofol on brain during pediatric parent liver transplantation.Methods40 pediatric patients in Tianjin First Central Hospital with congenital biliary atresia were prepared to do elective parent liver transplantation. There was no gender perference, age from six to nine months, their weight was from6 to9.5 kg, and ASA classification was Ⅲ or Ⅳ grade. They were randomly divided into two groups (n=20): propofol group(P group) and control group(C group). Their vein were opened after entering into operating room. They were injected with atropine0.01 mk/kg, midazolam0.10-0.15 mg/kg, etomidate0.2-0.3 mg/kg, fentany2-5μg/kg and vecuronium0.8-1.0 mg/kg through the venous pathway. They were carried out endotracheal intubation and mechanical ventilation after induction of anesthesia. Propofol were continuously pump-injected 9-15 mg/(kg·h) until the end of the surgery in P group.1%-2% sevoflurane were continuously inhaled in C group. Their blood samples were collected from central venous at the time of operation began(T0),30 min after anhepatic phase(T1),3 hours after hepato-reperfusion(T2),24 hours after hepato-reperfusion(T3). S100-β expression and neuron-specific enolase(NSE) were detected.Results There were no significant difference in basic information of pediatric patients(age, weight, anhepatic phase, anesthsic time, operation time, transfusion volume and urine volume). Compared with T0,the concentration of S100-βand NSE were in serum increased at T1, T2 in P and C groups〔C group,S100-β(ng/ml):11.29±3.45、8.66±1.57 vs. 5.26±0.94,P<0.05,NSE(ng/ml):26.92±4.43、24.57±4.12 vs.20.68±2.94,P<0.05;P group:S100-β(ng/ml):9.28±1.85、6.47±0.86 vs.4.91±1.25,P<0.05,NSE(ng/ml):24.50±3.26、22.23±3.07 vs.19.89±4.40, P<0.05〕. Compared with C group, the concentration of serum S100-βand NSE were decreased in P group at T1-T3〔S100-β(ng/ml):9.28±1.85 vs.11.29±3.45、6.47±0.86 vs.8.66±1.57、5.49±0.79 vs.6.36±1.42, P<0.05;NSE(ng/ml):24.50±3.26 vs.26.92±4.43、22.23±3.07 vs.24.57±4.12、20.04±20.71 vs.21.94±3.07, P<0.05〕.Conclusion Propofol can alleviate brain injury during pediatric parent liver transplantation.
出处 《实用器官移植电子杂志》 2015年第6期342-345,共4页 Practical Journal of Organ Transplantation(Electronic Version)
基金 天津市卫生局科技攻关项目(13KG105)
关键词 肝移植 异丙酚 七氟烷 脑保护 Liver transplantation Propofol Sevoflurane Brain protection
  • 引文网络
  • 相关文献

参考文献11

  • 1Shapiro M.Plasticity, hippocampal place cells, and cognitive maps. Archives of Neurology . 2001
  • 2RJ Sokol,RW Shepherd,R Superina.Screening and outcomes in biliary atresia: summary of National Institutes of Health workshop. Hepatology . 2007
  • 3任晓玲,桂军云,李海波,李发展,林钦英.大鼠颅脑损伤急性期脑组织NF-κB、TNF-α的表达及丙泊酚的干预效应[J].现代医药卫生,2011,27(9):1283-1284. 被引量:7
  • 4顾向前,高伟,蔡金贞,孙超,马楠,董冲,滕大洪,郑虹.胆道闭锁患儿活体肝移植和全肝移植术后早期肝功能的比较[J].实用器官移植电子杂志,2014,2(5):289-293. 被引量:7
  • 5冯春生,麻海春,岳云,曲向东,张永谦.丙泊酚对大鼠局灶性脑缺血-再灌注时脑组织热休克蛋白70基因和蛋白表达的影响[J].临床麻醉学杂志,2006,22(3):207-210. 被引量:4
  • 6D.R. Cui,L. Wang,W. Jiang,A.H. Qi,Q.H. Zhou,X.L. Zhang.??Propofol prevents cerebral ischemia-triggered autophagy activation and cell death in the rat hippocampus through the NF-κB/p53 signaling pathway(J)Neuroscience . 2013
  • 7Laszlo Vutskits.??Anesthetic-Related Neurotoxicity and the Developing Brain(J)Pediatric Drugs . 2012 (1)
  • 8Hong-jie Xi,Tian-hua Zhang,Tao Tao,Chun-yu Song,Shu-jun Lu,Xiao-guang Cui,Zi-yong Yue.??Propofol improved neurobehavioral outcome of cerebral ischemia–reperfusion rats by regulating Bcl-2 and Bax expression(J)Brain Research . 2011
  • 9Greg Stratmann,Laura D. V. May,Jeffrey W. Sall,Rehan S. Alvi,Joseph S. Bell,Brandi K. Ormerod,Vinuta Rau,Joan F. Hilton,Ran Dai,Michael T. Lee,Kavel H. Visrodia,Ban Ku,Emanuel J. Zusmer,Jeremy Guggenheim,Atoosa Firouzian.??Effect of Hypercarbia and Isoflurane on Brain Cell Death and Neurocognitive Dysfunction in 7-day-old Rats(J)Anesthesiology . 2009 (4)
  • 10Fuat H. Saner,Silvio Nadalin,Arnold Radtke,Georgios C. Sotiropoulos,Gernot M. Kaiser,Andreas Paul.??Liver transplantation and neurological side effects(J)Metabolic Brain Disease . 2009 (1)

二级参考文献22

  • 1李龙,付京波,余奇志,黄柳明,贾军,刘宝富,王淑芹,雷宇,刘钢,王平.小儿尸体肝移植探讨[J].中华小儿外科杂志,2004,25(6):41-43. 被引量:5
  • 2朱志军.单中心儿童活体肝移植总结以及国际经验交流[J].实用器官移植电子杂志,2013,1(1). 被引量:4
  • 3Li-Ying Sun,Yun-Sheng Yang,Zhi-Jun Zhu,Wei Gao,Lin Wei,Xiao-Ye Sun,Wei Qu,Wei Rao,Zhi-Gui Zeng,Chong Dong,Jin-Peng Tu,Jian Wang,Yi-He Liu,Yuan Liu,Li-Xin Yu,Yu Wang,Jing Li,Zhong-Yang Shen.Outcomes in children with biliary atresia following liver transplantation[J].Hepatobiliary & Pancreatic Diseases International,2013,12(2):143-148. 被引量:8
  • 4唐映梅,何晓顺,陈规划,陈旻湖.肝移植术后早期肝功能的动态变化及其对预后的价值[J].中华内科杂志,2005,44(4):268-271. 被引量:18
  • 5Li CY,Lee JS,Ko YG,et al.Heat shock protein 70 inhibits apoptosis downstream of cytochrome c release and upstream of caspase-3 activation.J Biol Chem,2000,275:25665-25671.
  • 6Yamaguchi S,Hamaguchi S,Mishio M,et al.Propofol prevents lipid peroxidation following transient forebrain ischemia in gerbils.Can J Anaesth,2000,47:1025-1030.
  • 7Wagstaff MJ,Collalo-Moraes Y,Aspey BS,et al.Focal cerebral ischaemia increases the levels of several classes of heat shock proteins and their corresponding mRNAs.Brain Res Mol Brain Res,1996,42:236-244.
  • 8Kondo T,Murakami K,Honkaniemi J,et al.Expression of hsp70 mRNA is induced in the brain of transgenic mice overexpressing human CuZn-superoxide dismutase following transient global cerebral ischemia.Brain Res,1996,737:321-326.
  • 9Ravagnan L,Gurbuxani S,Susin SA,et al.Heat-shock protein 70 antagonizes apoptosis-inducing factor.Nat Cell Biol,2001,3:839-843.
  • 10Hans P,Bonhomme V,Collette J,et al.Propofol protects cultured rat hippocampal neurons against N-methyl-D-aspartate re ceptor-mediated glutamate toxicity.J Neurosurg Anesthesiol,1994,6:249-253.

共引文献16

同被引文献25

引证文献4

二级引证文献150

相关主题

;
使用帮助 返回顶部