异丙酚对高血压性脑出血行开颅血肿清除术炎性细胞因子的影响研究

目的异丙酚对行开颅血肿清除术高血压性脑出血（HICH）患者炎性细胞因子水平的影响。方法 60例拟择期行开颅血肿清除术的HICH患者分为观察组和对照组。观察组采用术中异丙酚持续靶控输注,对照组采用术中异氟醚持续吸入维持。分别于麻醉诱导前10 min（T0）、手术开始后4 h（T1）、术后24 h（T2）、术后48 h（T3）4个时点测定血浆白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）的含量。结果观察组T1和T2血浆IL-6和TNF-α水平与T0比较明显升高,相比较差异有统计学意义（P〈0.05）,T3基本达到T0水平,且T1-T3三个时点血浆IL-6和TNF-α水平与对照组比较差异有统计学意义（P〈0.05）。结论异丙酚能减少行开颅血肿清除术HICH患者血浆炎性因子的释放和抑制炎症反应。

Effect of Propofol on Inflammatory Cytokines in FILCH Patients Treated with Craniotomy with Evacuation of Hematoma

Objective To evaluate the effect of propofol on inflammatory cytokines in patients of hypertensive cerebral hemorrhage(HICH) treated with craniotomy for evacuation of hematoma. Methods Sixty HICH patients underwent selective craniotomy procedures were divided into observation group and control group.The patients in observation group received target-controlled infusion anesthesia using intraoperative propofol,while the patients in control group received anesthesia maintained by intraoperative isoflurane inhalation.Before induction of anesthesia 10 min(T0),after surgery 4 h(T1),24 h(T2) and 48 h(T3),the plasma interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) levels of the two groups were detected. Results The plasma IL-6 and TNF-α levels of observation group at T1 and T2 were higher than those of T0,and there were statistically significant differences (P<0.05).The plasma IL-6 and TNF-α levels at T3 reached the level of T0,and there were statistically significant differences in the plasma IL-6 and TNF-α levels at T1～T3 between observation group and control group(P<0.05). Conclusions Target-controlled infusion anesthesia using intraoperative propofol can significantly reduce the release of inflammatory cytokines and inhibit the inflammatory response in HICH patients treated with craniotomy for evacuation of hematoma.