控制性降压联合急性高容量血液稀释对脑动脉瘤夹闭术后S100β和NSE的影响

Effects of deliberate hypotension combined with hypervolemic hemodilution on concentration of serum S100βAND NSEundergoing intraeranial aneurysmsurgery

目的研究控制性降压联合急性高容量血液稀释对脑动脉瘤夹闭术后S100和NSE的影响。方法 40例择期行脑动脉瘤手术患者,ASA分级Ⅰ-Ⅱ级,随机分为两组:控制性降压联合急性高容量血液稀释组(S组)与单纯行控制性降压组(C组),每组20例。两组患者均采用尼卡地平予以控制性控制性降压,S组在控制性降压过程中予以急性高容量血液稀释,C组予以单纯行控制性降压。分别在控制性降压前(T1)、控制性降压结束后(T2)、手术结束后(T3)、术后48h(T4)抽血,用ELISA试剂盒检测血中S100β和NSE浓度。结果①两组患者年龄、性别、手术时间、术中出血量、术中麻醉药使用量比较、控制性降压时间,差异无统计学意义(P】0.05);两组患者均未发生动脉瘤破裂。②在控制性降压前,与C组比较,S组血中S100β和NSE浓度差异无统计学意义;在控制性降压结束后、手术结束后、术后48h,与C组比较,S组血中S100β和NSE浓度明显下降,差异有统计学意义(P【0.05)。结论控制性降压联合超容血液稀释降低了单纯控制性降压对动脉瘤手术脑细胞的损害,具有一定脑保护作用。

Objective To observe the effects hypotension combined with hypervolemic hemodilution on concentration of serum S100βAND NSE undergoing intraeranial aneurysm surgery.Motheds Forty Patients undergoing intraeranial aneurysm intervention(ASAⅠ-Ⅱ) were randomly divided into two groups:S group(hypotension combined with hypervolemic hemodilution) and C group(hypotension),twenty in each hypervolemic hemodilutiongroup.In two groups,nicardipine was infused for deliberate hypotension.Hypervolemic hemodilution were done undergoing deliberate hypotension).Blood samples were taken at before deliberate hypotension(TI)、after deliberate hypotension(T2)、aneurysm、48h after aneurysm for determination of serum S100βand NSE with ELISA.Results There is no significant difference on ages、gender 、amount of blood on between two groups.2、There is no significant difference on concentration of serum S100βand NSE at T1.The concentration of serum S100βand NSE in S group were significantly lower than in C group at T2、T3、T4.Conclusion Deliberate hypotension combined with hypervolemic hemodilution lower the danger of brain injury with only Deliberate hypotension.