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目的观察颅内动脉瘤夹闭术行异氟醚控制性降压对血流动力学及血清β２微球蛋白（β２－ＭＧ）含量变化的影响．方法２１例颅内动脉瘤病人于全麻下剥离夹增长动脉瘤时，加大异氟醚吸入浓度，使ＭＡＰ下降２０％～３０％，夹闭动脉瘤后，减少异氟醚浓度，ＭＡＰ回升至降压前水平．采用Ｓｗａｎ－Ｇａｎｚ漂浮导管监测降压前、中、后心血流动力学各指标动态变化．同时测定相应阶段血β２－ＭＧ．结果降压期间ＣＯ，ＣＩ，ＳＶ，ＳＩ，ＣＶＰ，ＰＣＷＰ，ＲＶＳＷＩ，ＬＶＳＷＩ，ＳＰＡＰ，ＤＰＡＰ，ＭＰＡＰ，ＨＲ无显著性变化，ＳＶＲ，ＰＶＲ，Ｃｐｐ，Ｒｐｐ显著减少．降压前后血清β２－ＭＧ含量无变化．结论异氟醚控制性降压能维持良好的心肌氧供需平衡和心肌功能，对肾小球滤过率无明显影响．
Objective To observe the effect of isoflurane-controlled hypotension on hemodynamics and serum β2-microglobulin (β2-MG) content in patients with intracranial aneurysm clipping. Methods Twenty-one patients with intracranial aneurysm underwent dissection and aneurysm dissection under general anesthesia. The inhalation concentration of isoflurane was increased and the MAP decreased by 20% -30%. After the aneurysm was occluded, the isoflurane concentration was reduced and the MAP recovery To the level of pre-buck. Swan-Ganz floating catheter was used to monitor the dynamic changes of cardiac hemodynamics before, during and after blood pressure lowering. Simultaneous determination of the corresponding phase of blood β2-MG. Results There was no significant change in CO, CI, SV, SI, CVP, PCWP, RVSWI, LVSWI, SPAP, DPAP, MPAP and HR during depressurization. SVR, PVR, Cpp and Rpp were significantly decreased. Before and after antihypertensive serum β2-MG content did not change. Conclusions Isoflurane-controlled antihypertensive treatment can maintain a good myocardial oxygen supply and demand balance and myocardial function, and has no significant effect on glomerular filtration rate.