兰州大学机构库 >学院待认领
亚低温在脑瘤切除术中的应用
Alternative TitleThe application of mild hypothermia in the resection operation of cerebrom
靳琪
Subtype硕士
Thesis Advisor马永丰
2007-03-21
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Degree Discipline麻醉学
Keyword亚低温 神经元特异性烯醇化酶 氧自由基 电解质
Abstract目的:考察术中亚低温对脑瘤切除术中病人血清 NSE(神经元特异性烯醇化酶). SOD(超氧化物歧化酶)及 MDA(丙二醛)和电解质变化的影响,初步评价其在脑瘤手术中应用的可行性和意义。方法:选择36例ASAⅡ-Ⅲ级胶质瘤择期手术患者。随机分为亚低温组(A组)18例病人和常温组(B组)18例病人。亚低温组诱导后实施全身降温,在硬脑膜打开前将脑温降至并维持在34℃-35℃之间,硬脑膜关闭后开始复温,常温组维持正常体温(36℃-37℃)。记录术前(T1)、诱导后(T2)、术中2小时(T3)、术毕时(T4)和术后次日清晨(T5)两组病人的心率、平均动脉压和血氧饱和度。于T1、T3、T4和T5时点采血测血清NSE和SOD、MDA含量。两组病人均于T1、T3和T5时点采血查电解质。结果:1.一般资料:两组病人的体重、年龄、性别、手术时间、肿瘤性质等基线资料均无统计学差异。2.围术期血流动力学的变化:T3 和 T4 时点降温组的心率低于常温组(P<0.05)。3.血清 NSE 浓度的变化:T5 时点降温组的 NSE 值低于常温组(P<0.05)。4.血清 SOD 及 MDA 浓度的变化:T3 和 T4 时点降温组的 SOD 值高于常温组(P<0.05),而 MDA 值则低于常温组(P<0.05)。5.降温组钾离子和钙离子在术中 2 小时(T3) 较常温组降低(P<0.05)。结论:术前诱导的亚低温(34℃-35℃)可减轻脑瘤切除术中的脑损伤,起到一定的脑保护作用(达到术中脑保护的目的),并且是安全可行的。
Other AbstractAIM:To investigate the effect of mild hypothermia used in the resection operation of cerebroma on NSE ( neuron-specific enolase), SOD (Superoxide dis- mutase), MDA (Malondialdehyde) and Dielectric, To evaluate its clinical signification. and feasibility used in cerebroma operation primaryly. METHODS:Thirty – six neurogliocytoma patients ASAⅡ- grade were randomly Ⅲdivided into hypothermic (A)groups and normothermic (B)groups.In the mild hypoth-ermic group,After the patients were induced,the patients brain thermo were subdued and maintained at 34℃-35 before the dura was opene ℃ d,then, when the dura was closed,we start rewarming. In the normothermic group, the patients brain thermo were maintained at 36℃-37 .Recorded the HR,MAP, ℃ and saturation of blood oxygen at before operation(T1) ,after induction(T2), 2 hour after operation(T3) , completion of the operation(T4),and the next days morning (T5).The NSE,SOD,MDA were measured at T1, T3, T4,and T5. And the dielectric were measured at T1、T3 and T5. RESULTS: 1 General patient data:The two group's baseline data is no statistic difference such as. Body weight,. gender,age and operation time. 2.The change of.hymodynamid:The HR at T3 and T4 in patients of mild hypothermia group were significantly lower than those of non.mild hypothermia group( P < 0. 05). 3.Change in the serum density of NSE:The serum density of NSE at T5in patients of mild hypothermia group were significantly lower than those of non.mild hypothermia group ( P < 0. 05) 4. Change in the serum density of SOD and MDA.:The serum density of SOD at T3 and T4 in patients of mild hypothermia group were significantly higher than those of non.mild hypothermia group(P <0.05), Meanwhile the serum density of MDA were significantly lower. 5.Change in the plasma density of dieletric:The plasma density of kalium ion and calcium ion at T3 in patients of mild hypothermia group were significantly lower than those of non.mild pothermia group ( P < 0. 05). CONCLUSION: Mild hypothermia (34℃-35 ) started before operation and ℃maintained during operation can effectively protect brain tissues in operation of cerebroma patients and it is be used safely in these patients.
Pages42
URL查看原文
Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/341588
Collection学院待认领
Affiliation
临床医学院
Recommended Citation
GB/T 7714
靳琪. 亚低温在脑瘤切除术中的应用[D]. 兰州. 兰州大学,2007.
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