异丙酚和异氟烷在瓣膜置换术中对脑保护作用的比较临床医学.docVIP

异丙酚和异氟烷在瓣膜置换术中对脑保护作用的比较临床医学 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：异丙酚和异氟烷在瓣膜置换术中对脑保护作用的比较临床医学 1 1 资料与方法 3 2 结果 4 3 讨论 4 文2：异丙酚和七氟烷对小儿体外循环心肌保护作用的对比研究 6 1 资料与方法 7 2 结果 8 3 讨论 9 参考文摘引言： 10 原创性声明（模板） 12 文章致谢（模板） 12 正文 异丙酚和异氟烷在瓣膜置换术中对脑保护作用的比较临床医学 文1：异丙酚和异氟烷在瓣膜置换术中对脑保护作用的比较临床医学 The Comparison between Isoflurane and Propofol with Effect on Cerebral Protection in Cardiac Valve Replacement Surgery Abstract: OBJECTIVE To observe the effects of isoflurane and propofol on the changes of cerebral oxygen metabolism and blood concentration of S100β protein in cardiac valve replacement surgery. METHODS Thirty patients scheduled for cardiac valve replacement surgery with extracorporeal circulation(ECC) were randomly assigned into two groups，isoflurane group and propofol group. The radial arterial and jugular venous bulb oxygen saturation were recorded at four time points after anaesthesia, ECC 10 min, before aortic opening 5 min and after ECC 30 min. The jugular venous blood was taken at the four time points to measure the blood concentration of S100β protein. RESULTS The jugular venous bulb oxygen saturation in the two groups were both increased during cooling period and then decreased during warming period, but the change in isoflurane group is less than in the propofol group（P）. The blood concentratio of S100β protein were both increased after ECC, but the concentratio protein in propofol group were lower than in isoflurane group （P）. CONCLUSION Propofol has better cerebral protection effects than isoflurane in cardiac valve replacement surgery with ECC. Key words： Oxygen saturation;S100β protein;Cerebral protection 中枢神经损伤是体外循环（extracorporeal circulation，ECC）下心脏手术的主要并发症之一，其主要原因有缺血、缺氧、栓塞及温度的变化等，其中氧合失衡尤其是脑的氧合失衡更是不容忽视。一些 文献 报道［1-2］，选用合适的麻醉药和麻醉方法可减轻这种失衡，有利于脑保护。本实验拟通过测定脑氧代谢及脑损伤标志蛋白质S100β蛋白，比较以异丙酚和芬太尼为主的全凭静脉麻醉与以异氟烷和芬太尼为主的静吸复合麻醉对脑氧供需平衡的影响，并通过测定脑损伤标志蛋白质S100β蛋白的浓度比较两种麻醉方法对脑的保护作用。 1 资料与方法 一般资料 择期ECC下瓣膜置换术30例(二尖瓣置换术20例，主动脉瓣置换术4例，二尖瓣置换三尖瓣成形术6例)，均无高血压及中枢神经系