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目的探讨婴幼儿体外循环手术中氯胺酮对患者血浆S-100β和肿瘤坏死因子-α的影响。方法 30例拟在体外循环下行心内直视手术的先天性心脏病患儿,随机分为氯胺酮组(K组)与对照组(C组),每组15例。K组转流前经中心静脉泵入氯胺酮1 mg/kg;C组给予等量平衡液。分别于转流前和转流完毕时检测血浆S-100β和肿瘤坏死因子-α水平。结果转流前2组S-100β和TNF-α水平差异无统计学意义(P>0.05);转流后2组S-100β和TNF-α水平均较转流前升高(P<0.05);转流后C组S-100β和TNF-α水平明显高于K组(P<0.05)。结论氯胺酮对体外循环心脏手术诱发的脑损伤中有一定保护作用,其机制可能与抑制内源性炎性因子释放有关。
Objective To investigate the effects of ketamine on plasma S-100β and tumor necrosis factor-α in infants with cardiopulmonary bypass. Methods Thirty patients with congenital heart disease undergoing open heart surgery under cardiopulmonary bypass were randomly divided into ketamine group (K group) and control group (C group), 15 cases in each group. In group K, Ketamine 1 mg / kg was injected through the central venous tract before commutation. The rats in group C were given the same amount of equilibration solution. Plasma levels of S-100β and tumor necrosis factor-α were measured before and at the end of each bypass. Results There was no significant difference in the levels of S-100β and TNF-α between the two groups before commutation (P> 0.05). The levels of S-100β and TNF-α in both groups were significantly higher than those before commutation (P <0.05) The levels of S-100β and TNF-α in C group were significantly higher than those in K group (P <0.05). Conclusions Ketamine has a protective effect on brain injury induced by cardiopulmonary bypass. Its mechanism may be related to the inhibition of the release of endogenous inflammatory cytokines.