七氟醚与体外循环脑损伤保护作用研究进展

心血管外科手术中,体外循环术后的神经系统并发症可延长住院时间、增加死亡率及其他并发症,已成为阻碍心外科手术发展的重要因素。七氟醚作为一种具有神经保护作用的吸入性麻醉药正在逐渐引起人们的重视,本文结合国内外相关的七氟醚与脑缺血再灌注损伤的基础与临床研究,总结目前研究现状以及存在问题,从以下几个方面对七氟醚在体外循环脑损伤中的脑保护作用进行阐述:七氟醚增加脑血流、降低脑氧代谢率;线粒体ATP敏感性钾通道介导七氟醚神经保护的作用;TLR与心血管手术脑保护研究;七氟醚预处理后处理与心血管手术;七氟醚在心血管手术中脑保护作用。基于目前研究,为了确保七氟醚在心血管手术麻醉中更有效、安全地应用,有关七氟醚体外循环脑损伤保护作用的复杂机制及七氟醚最佳使用剂量-保护效应之间的关系仍需要进一步的探索,以期为临床提供理论基础。

Advanced Study of Sevoflurane and its Neuroprotection during Cardiopulmonary Bypass

Because the postoperative neurological complications of CPB can extend the length of hospital stay, increase the mortality rates and cause other complications, it has been one the most important factor to hinder the development of cardiac surgery. Sevoflurane, as a kind of neuroprotective inhalation anesthetics, is gradually arousing people''s attention. This article combined the relevant basic and clinical research in domestic and foreign to expound the neuroprotection of sevoflurane against cerebral ischemia injury fromthe following aspects: Sevoflurane can increase the cerebral blood flow and decrease the rate of cerebral oxygen metabolism; Mitochondrial ATP channel medicates the neuroprotection of Sevoflurane; The research of TLR and neuroprotection during cardiac surgery; Preconditioning and postconditioning during cardiac surgery; The neuroprotection of Sevoflurane during cardiac surgery. To ensure the sevoflurane can applied in cardiac anesthesia more effective and safer, the complex neuroprotective mechanisms and optimal dose-protective effect of sevoflurane during cardiopulmonary bypass need more explore.