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丙泊酚与七氟醚用于体外循环心脏手术患者的效果比较。

Comparison of effects of propofol versus sevoflurane for patients undergoing cardiopulmonary bypass cardiac surgery.

作者信息

Tang Shaoqun, Huang Wei, Zhang Kun, Chen Wei, Xie Tao

机构信息

Shaoqun Tang, Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.

Wei Huang, Department of Neurology, Taihe Hospital Hubei University of Medicine, Shiyan, Hubei 442000, China.

出版信息

Pak J Med Sci. 2019 Jul-Aug;35(4):1072-1075. doi: 10.12669/pjms.35.4.1279.

Abstract

OBJECTIVE

To compare the effects of propofol versus sevoflurane on the outcomes of patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).

METHODS

A total of 110 patients undergoing cardiac surgery with CPB in our hospital from January 2015 to June 2017 were randomly divided into 2 groups (n=55): Group A, in which anesthesia was maintained with sevoflurane, and Group B, in which anesthesia was maintained with propofol. The MMSE score before and after operation, perioperative laboratory index, incidence of postoperative cognitive dysfunction (POCD) and incidence of adverse events between the two groups were compared.

RESULTS

The MMSE score was significantly higher in Group B than in Group A after anesthesia (p<0.05). Serum levels of the brain injury markers neuron-specific enolase, S100β and matrix metalloproteinase 9 were significantly lower in Group B than in Group A (p<0.05). POCD incidence at 12 hour and 24 hour after operation was significantly lower in Group B than in Group A (p<0.05). There were no significant differences in the incidence of low cardiac output and thoracotomy bleeding between two groups.

CONCLUSION

Compared with sevoflurane, the use of propofol during cardiac surgery with CPB can efficiently improve postoperative cognitive function without increasing the risk of adverse reactions.

摘要

目的

比较丙泊酚与七氟醚对接受体外循环心脏手术患者预后的影响。

方法

选取2015年1月至2017年6月在我院接受体外循环心脏手术的110例患者,随机分为2组(n = 55):A组,采用七氟醚维持麻醉;B组,采用丙泊酚维持麻醉。比较两组患者手术前后的简易精神状态检查表(MMSE)评分、围手术期实验室指标、术后认知功能障碍(POCD)发生率及不良事件发生率。

结果

麻醉后B组的MMSE评分显著高于A组(p < 0.05)。B组血清脑损伤标志物神经元特异性烯醇化酶、S100β和基质金属蛋白酶9水平显著低于A组(p < 0.05)。术后12小时和24小时B组的POCD发生率显著低于A组(p < 0.05)。两组低心排血量和开胸出血量发生率无显著差异。

结论

与七氟醚相比,体外循环心脏手术中使用丙泊酚可有效改善术后认知功能,且不增加不良反应风险。

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