【摘要】 目的:探讨七氟烷麻醉对急性创伤性颅脑损伤患者围手术期炎症介质表达、神经功能损害及患者预后的影响。方法:收集2015年7月至2016年12月急诊开颅手术的创伤性颅脑损伤患者80例,随机分为试验组(七氟烷处理组)和对照组,各40例。围手术期抽取外周血,利用酶联免疫吸附测定法检测血清中TNF-α、IL-6、CRP蛋白和NSE浓度,比较两组患者GCS评分、APACHEⅡ评分和预后。结果:与对照组比较,试验组在术中1 h、术毕和术后第1天血清炎症介质(CRP、TNF-α、IL-6)表达明显降低(P<0.05或0.01),神经元特异性烯醇化酶NSE蛋白在术毕及术后第1天表达降低(P<0.05或0.01);七氟烷处理有效改善患者病情,在第14天GCS评分[(10.82±1.40)比(8.29±1.02),P=0.03],APACHEⅡ评分[(14.42±1.97)比(18.03±2.15),P=0.02]。结论:七氟烷处理可通过抑制创伤性颅脑损伤患者围手术期伤后炎症反应,减少神经元细胞损害,起到神经保护作用和改善患者预后。更多还原

【Abstract】 Objective: To investigate the effects of Sevoflurane on inflammatory response,neuro damage and the prognosis on surgery patients with traumatic brain injury( TBI). Methods: From July 2015 to December 2016,80 TBI patients undergoing neurosurgery were randomly divided into experimental group( Sevoflurane treatment,n = 40) and control group( n = 40). The serum levels of TNF-α,IL-6,C-reactive protein( CRP) and neuron specific enolase( NSE) were tested with enzyme linked immunosorbent Assay( ELISA). GCS score,APACHEⅡ score and prognosises of the two groups were also compared. Results: Compared with control group,the serum levels of inflammatory related factors( CRP,TNF-α,IL-6) in the experimental group were significantly decreased in 1hour of intraoperative,at the end of surgery and on 1st day after surgery respectively( P < 0. 05 or 0. 01). Meanwhile,NSE protein expressions were significantly decreased( P<0. 05 or 0. 01). The experimental group received better prognosis compared to the control group,GCS scores[( 10. 82±1. 40) vs( 8. 29±1. 02),P = 0. 03],APACHEⅡ scores[( 14. 42±1. 97) vs( 18. 03±2. 15),P = 0. 02]on the 14 th day. Conclusion: Sevoflurane treatment can effectively regulate the inflammatory response,reduce the neurons damage in surgery patients with TBI,possibly playing brain protection effect.更多还原