摘要
目的对比采用多功能经颅骨颅内穿刺针持续颅内压(ICP)监测对不同全身麻醉(全麻)诱导方式行的指导。方法对颅脑创伤手术患者术前行快速ICP监测,其中男39例,女33例,随机数字表法分为常规诱导组(丙泊酚)和依托咪酯组,根据动态监测脑灌注压(CPP)和ICP观察两种诱导药物使用后的变化,以调整诱导药物使用。术前利用多功能经颅骨颅内穿刺针监测ICP、CPP;比较两组患者麻醉前(T0)、诱导中(T1)、插管前(T2)、插管时(T3)、插管后(T4)患者平均动脉压(MAP)、ICP、CPP、心率(HR)的变化。结果在麻醉诱导前两组ICP、MAP、CPP、HR、血氧饱和度(SpO2)指数均差异无统计学意义(P>0.05)。麻醉诱导后两组各指标均出现不同程度的变化,MAP、CPP下降程度更显著(P<0.05)。两组ICP、MAP及CPP在不同时间点(T1、T2、T3)变化差异有统计学意义(P<0.05)。结论运用多功能经颅骨颅内穿刺针ICP传感器置入在颅脑创伤手术中可有效地监测ICP、CPP变化,并能指导调整全麻诱导期药物的使用。
Objective To compare the guidance of multi-functional intracranial puncture needles for transcranial intracranial pressure(ICP)monitoring to different general anesthesia induction modes.Methods The preoperative fast ICP monitoring was conducted in the patients undergoing traumatic brain surgery.Among them,there were 39 males and 33 females.They were randomly divided into the conventional induction group(propofol)and the etomidate group.According to the dynamic monitoring of cerebral perfusion pressure(CPP)and ICP,the changes after two induction drugs use were observed to adjust the induction drug use.Before surgery,ICP and CPP were monitored by multi-functional transcranial intracranial puncture needles.The changes of mean arterial pressure(MAP),ICP,CPP and heart rate(HR)before anesthesia(T0),during the induction(T1),before the catheterization(T2),intubation(T3)and after intubation(T4)were compared between the two groups.Results ICP,MAP,CPP,HR,and SpO 2 indexes before induction of anesthesia had no statistical differences between the two groups(P>0.05).After induction of anesthesia,various indexes of the two groups appeared varying degrees of changes.The MAP and CPP decreased degree were more significant(P<0.05).ICP,MAP and CPP at different time points(T1,T2,T3)had statistical differences between the two groups(P<0.05).Conclusion The use of multi-function transcranial intracranial puncture needle ICP sensor implantation can effectively monitor the changes of ICP and CPP,moreover can guide to adjust the drug use during anesthesia induction period.
作者
袁鹏
雍浩川
熊伟茗
王佳
唐彦明
邹胜伟
陈菲
YUAN Peng;YONG Haochuan;XIONG Weiming;WANG Jia;TANG Yanming;ZOU Shengwei;CHEN Fei(Department of Neurosurgery,Affiliated Central Hospital of Chongqing University,Chongqing 400014,China;Department of Orthopedics,Affiliated Central Hospital of Chongqing University,Chongqing 400014,China;Department of Anesthesiology,Affiliated Central Hospital of Chongqing University,Chongqing 400014,China)
出处
《重庆医学》
CAS
2019年第5期788-791,共4页
Chongqing medicine
基金
重庆市卫生和计划生育委员会医学科研重点项目(2013-1-041)
关键词
颅脑创伤
颅内压监测
全麻诱导期
多功能经颅骨颅内穿刺针
brain trauma
intracranial pressure monitoring
induction period of general anesthesia
multi-function transcranial intracranial puncture needle
作者简介
袁鹏(1975-),副主任医师,本科,主要从事颅脑创伤、脑血管病,脑肿瘤的研究工作。
