高渗氯化钠羟乙基淀粉40注射液对肝肿瘤并高血压患者硬膜外复合全身麻醉诱导期的脑保护作用

观察预注高渗氯化钠羟乙基淀粉40注射液对肝肿瘤合并高血压患者硬膜外复合全身麻醉诱导期的脑保护作用。选择50例患有高血压ASA分级Ⅱ级～Ⅲ级肝肿瘤手术患者,随机分为高渗氯化钠羟乙基淀粉40注射液(H)组和复方氯化钠(复方乳酸林格液R)组,每组25例。于输注前(T0)、输注完毕即刻(T1)、气管插管后即刻(T2)、气管插管后5min(T3)、气管插管后15min(T4)、气管插管后30min(T5)抽取静脉血离心后检测血清中S100B、IL-6、TNF-a的浓度。与T0点相比,H组,T5点S100B轻度降低但无统计学差异(P0.05),IL-6、TNF-a无明显变化(P0.05);R组在T5点S100B明显上升(P0.01);IL-6、TNF-a明显上升(P0.05或P0.01)。与R组相比,H组患者在T3-5时点S100B、IL-6和TNF-a均低(P0.05或P0.01)。结论为预注高渗氯化钠羟乙基淀粉40注射液在肝肿瘤合并高血压患者硬膜外复合全身麻醉诱导期具有脑保护作用。

Cerebral Protection of Hypertonic Sodium Chloride Hydroxyethyl Starch--40 Injection on Liver Tumor Patients with Hypertension in Combined General-- epidural Anesthesia Induction Period

To investigate the Cerebral protection of hypertonic sodium chloride hydroxyethyl starch--40 injection on liver tumor patients with hypertension in combined general--epidural anesthesia induction period. Fifty hypertension patients （ASA Ⅱ-Ⅲ ） undergoing tumor of liver were randomly divided into 2 groups： group H （hypertonic sodium chloride hydroxyethyl starch--40 injection）, group R （Sodium chloride compound）（n= 25）. Time--point was marked as：before solution infusion （T0）, immediate after infusion （ T1 ）, immediate after tracheal intubation （T2）, 5 min （T3） after trache- al intubation, 15 rain （T4） after tracheal intubation, 30 rain （T5） after tracheal intubation. Serum S100B,IL-- 6 and TNF --a were measured at these time--points respectively. Compared with TO, group H, S100B reduced slightly（P〉0.05 ）, IL --6.TNF--a have no marked change. Group H, S100B increased obviously at T5（P〈0.01）, IL--6.TNF--a increased obviously（P〈0.05 or P〈0.01 ）. Compared with group R, S100B.IL--6 and TNF--a of group H reduced obviously from T3 to TS（P〈0.05 or P〈0.01）. Hypertonic sodium chloride hydroxyethyl starch--40 injection may have cerebral protec- tion on hypertension patients in combined general epidural anesthesia induction period.