丙泊酚在颅脑损伤手术中的效果观察及对血清CRP、PCT水平的影响

目的:分析丙泊酚在颅脑损伤手术中的效果及对血清C反应蛋白(CRP)、降钙素原(PCT)水平的影响。方法:选择2016年6月-2019年6月我院收治的颅脑损伤手术患者90例纳入本次研究,根据麻醉方式分为观察组(n=46)和对照组(n=44)。对照组使用依托咪酯进行麻醉诱导,观察组采用丙泊酚进行麻醉诱导。比较两组患者呼吸恢复时间、睁眼时间、拔管时间、不同时间血清CRP、PCT、心率(HR)、平均动脉压(MAP)、收缩压(SBP)及舒张压(DBP)、简易智能量表(MMSE)、视觉模拟(VAS)评分的变化情况及不良反应的发生情况。结果:观察组呼吸恢复时间、睁眼时间、拔管时间均显著短于对照组(P0.05)。术前,两组血清CRP、PCT水平比较无显著差异;术中,两组血清CRP、PCT水平均较术前明显下降,且观察组术中血清CRP、PCT水平均显著低于对照组(P0.05);术前,两组HR、MAP、SBP及DBP水平无显著差异;术中,两组HR、MAP、SBP及DBP水平均较术前显著升高,且观察组术中HR、MAP、SBP及DBP水平均显著低于对照组,术后两组HR、MAP、SBP及DBP水平均较术中明显下降,且观察组术后以上指标显著低于对照组(P0.05);术前,两组MMSE、VAS评分水平无明显差异;术后,两组MMSE、VAS评分水平均较术前明显下降,且观察组MMSE评分水平均显著高于对照组,VAS评分水平显著低于对照组(P0.05);两组不良反应总发生率分别为4.35%、11.36%,组间比较差异无统计学意义(P0.05)。结论:丙泊酚可降低颅脑损伤手术患者术中血清CRP、PCT水平,稳定血流动力学,并发挥术后镇痛作用。

Effect of Propofolin on the Craniocerebral Injury Surgery and Serum CRP and PCT Levels

ABSTRACT Objective: To study the efficacy of propofolin in the Craniocerebral injury surgeryand its effectson the serum C-reactive protein (CRP), procalcitonin (PCT) levels. Methods: 90 patients with craniocerebral injury who admitted to our hospital from June 2016 to June 2019 were selected and divided into the observation group (n=46) and the control group (n=44). according to the anesthesia method. The control group was given with etomidate, and the observation group was treated by propofol. The changes of respiratory recovery time, eye-opening time, catheter extraction time, serum CRP, PCT, heart rate (HR), mean arterial pressure (MAP), systolic blood pressure (SBP) and diastolic blood pressure (DBP), simple intelligence scale (MMSE), visual simulation (VAS) scores before and after treatment and the occurrence of adverse reactions were compared between the two groups. Results: The respiratory recovery time, eye-opening time and extubation time of observation group were significantly shorter than those of the control group (P<0.05). Before surgery, there was no significant difference in the serum CRP and PCT levels between the two groups. During the operation, the serum CRP and PCT levels in both groups were significantly decreased compared with those before the operation, and serum CRP and PCT levels in the observation group were significantly lower than those in the control group (P< 0.05). Before surgery, there was no significant difference in the levels of HR, MAP, SBP and DBP between the two groups. During the operation, the levels of HR, MAP, SBP and DBP in the two groups were significantly higher than those before the operation, which were significantly lower in the observation group than those in the control group. After the operation, the levels of HR, MAP, SBP and DBP in the observation group were significantly lower than those in the control group (P< 0.05). Before surgery, there was no significant difference in MMSE and VAS scores between the two groups. After surgery, MMSE and VAS scores in the two groups decreased significantly compared with those before surgery, and MMSE scores in the observation group were significantly higher than those in the control group, while VAS scores were significantly lower than those in the control group (P<0.05). The total incidence of adverse reactions in the two groups was 4.35% and 11.36%, respectively, no significant difference was found between two groups(P>0.05). Conclusion: Propofol can reduce the serumCRP and PCT levels in patients undergoing craniocerebral injury surgery, stabilize hemodynamics, and play a role in the postoperative analgesia.