【摘要】 目的观察全麻诱导期药物应用对颅脑外伤所致脑损伤患者脑血流动力学的影响。方法入选近1a就诊于我院的颅脑外伤所致脑损伤患者64例,随机分为2组,对照组在全麻诱导期给予阿芬太尼,观察组给予瑞芬太尼,采用TCD在不同时期分别检测患者脑血流动力学相关参数。结果 2组输注药物后脑血管流速、平均动脉压和心率均较诱导期前明显降低,P<0.05;搏动指数和阻抗指数明显提高(P<0.05);气管插管前后平均动脉压和心率无明显变化(P>0.05);流速明显加快(P<0.05);搏动指数和阻抗指数明显升高(P<0.05)。应用瑞芬太尼较阿芬太尼血流速度在药物输注后和气管插管后下降更为显著(P<0.05);搏动指数和阻抗指数提高更为显著(P<0.05);但平均动脉压和心率组间差异无统计学意义(P>0.05)。结论在同等药物浓度情况下,瑞芬太尼对血流动力学的影响较为显著,阿芬太尼影响程度相对较小。更多还原

【Abstract】 Objective To investigate effects of cerebral hemodynamics for patients with craniocerebral trauma cured by different drugs in general anesthesia induction period.Methods 64 patients with craniocerebral trauma in recent 1year in our hospital were divided into two groups randomly,the control group was given alfentanil in the period of general anesthesia induction,while the observation group was given remifentanil.We detected the relative parameters of cerebral hemodynamics in 5different periods by TCD.Results After the application of the two drugs,the cerebrovascular velocity,mean arterial pressure and heart rate were significantly decreased than induction period(P<0.05)compared with pre-induction.Pulsatility index and resistance index increased significantly(P<0.05).The change of mean arterial pressure and heart rate had no significant after tracheal intubation(P>0.05).Velocity,pulsatility index and resistance index increased significantly(P<0.05).Blood flow velocity in observation group decreased significantly after tracheal intubation and drug infusion of Remifentani(P<0.05).In addition,pulsatility index and resistance index increased more significantly(P<0.05).Mean arterial pressure and heart rate had no significant differences(P>0.05).Conclusion In the same drug concentration of alfentanil,the effect of remifentanil on hemodynamics is more obvious.更多还原