单肺通气期间七氟醚或丙泊酚对脑氧代谢的影响

《单肺通气期间七氟醚或丙泊酚对脑氧代谢的影响》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。

1、392ChineseJournalofModemOperativeSurgery，Oct．2010，Vo1．14，No．5·临床论著·[文章编号]1009—2188(2010)05—0392—04单肺通气期间七氟醚或丙泊酚对脑氧代谢的影响戚翔，徐雪，张惠军，梁治，刘悦，董振明(河北医科大学第二医院麻醉科，石家庄050000)[摘要】目的观察单肺通气期间七氟醚或丙泊酚联合靶控持续输注瑞芬太尼对脑氧代谢的影响。方法选择行肺叶切除术患者30例，随机分为七氟醚组(S组)或丙泊酚组(P组)，每组各15例。麻醉诱导后，分别持续吸入七氟醚l％～2．5

2、％或静脉持续泵人丙泊酚4～8ms／(kg·h)。于双肺通气15min(T1)，单肺通气15min(T2)，单肺通气30min(T3)，恢复双肺通气之后15min(T4)时点记录HR、MAP及BIS值，同时采集桡动脉、颈内静脉球血行血气分析，测定颈静脉球氧饱和度(SjvO：)，并计算脑动静氧含量差(AjvDO：)及COER值。结果两组在T2、T3时点的PaO：值较T。时点明显降低(P<0．05)；S组各时点的SjvO：值、AjvDO2值、COER值与P组相应时点比较，无统计学差异(P>0．05)。结论单肺通气过程中七氟醚与丙泊酚联合瑞芬太

3、尼均能够达到满意麻醉效果，并保持脑氧供需平衡。[关键词】肺通气；七氟醚；二异丙酚；氧饱和度；脑氧代谢[中图分类号]R6l4[文献标识码]BEfectofSevofluraneorPropofolonCerebralOxygenMetabolismduringOne-lungVentilationQIXiang，XUXne，ZHANGHui-jun，HANGZhi，Yue，DONGZhen—mi，ig(DepartmentofAnesthesiology，theSecondHospitalofHebeiMedicalUniversity，

4、Shijiazhuang050000，Heibei，China)Abstract：ObjectiveToobservetheefectsofsevofluraneorpropofolrespectivelycombinedwithremifentanil百venbycontinuoustargetcontrolledinfusion(TCI)oncerebraloxygenmetabolismduringore—lungventilation(OLV)．Methods30patientsperformedopenwedgepulmona

5、rylobectomywererandomizedintogroupSandgroupP，with15easesforeach．Afteranesthesiainduction，themaintenanceofanesthesiawasa—chievedbycontinuousinhalationofsevofluranel％to2．5％togroupSandintravenousinfusionofpropafol4～8ms／kgperhourtoGroupP．TCIofremifentanilwasappliedinbothtwog

6、roups．Atthetimepointof15minutesaftertwo—lungventilation(T1)，15minutesafterOLV(T2)，30minutesafterOLV(T3)and15minutesaftertheterminationofOLV(Td)，HR，MAPandbispetralindex(BIS)wererecord，andbloodwasobtainedfromra_dialarteryandinternalcarotidveintoperformblood-gasanalysis：art

7、erialoxygenpress(PaO2)，arterialoxygensat—uration(SaO2)，arterialcarbondioxidetension(PaCO2)weremeasured．Theindexofcerebraloxygenmetabolismasjugularvenousoxygensaturation(SjvO2)，arterialtocerebralarteriovenousoxygencontentdiference(AjvDO2)andcerebraloxygenuptakerate(COER)w

8、eredetectedorcalculated．ResultsTherewasnostatisticaldiferenceofHR．MAPandBISbetweentwogroupsandamongintr