|
Objective: To observe Creatine Phosphate Sodium perioperative elderly patients with cerebral ischemia. Brain weight accounted for only 2% of the body weight, it accepted 15% of the cardiac output, less brain of oxygen and energy reserves, backup capillaries. Due to high supply, high consumption, low reserves, \Methods: Our hospital 2009-2010, 62 cases of elderly patients with preoperative examination revealed vertebral artery insufficiency, ASA Ⅱ - Ⅲ grade, age 55-73 years old, the average age (62 ± 3) years of age, according to the admission has cases were randomly divided : (100 ml of normal saline 1g Creatine Phosphate Sodium) for the two groups: (Ⅰ) control group: (100ml saline); (II) Phosphate Sodium treatment group, n = 31 cases. Parkinson's disease (s), Alzheimer's disease (s), Huntington chorea (s), multiple sclerosis, traumatic brain injury, autism, schizophrenia, depression, anxiety disorders, eating disorders, preoperative disease, peripheral nerve disease and other illnesses and suffering from underlying diseases of the central nervous system, liver disease, heart disease, renal dysfunction, pulmonary function abnormalities in patients were excluded. All patients 30 minutes before the intramuscular injection of pentobarbital sodium 0.1g, atropine 0.5mg. Datex-Ohmeda S / 5 monitor routine custody after burglary, anesthesia face mask before the induction of pre-oxygen for 5 minutes, a peripheral vein in turn given midazolam (Midazolam) 0.03mg/kg, fentanyl (Fentany) - 4ug/kg, atracurium (Atracurium) 0.7-0.8mg/kg, etomidate (Etomidate) 0.3mg/kg by rapid tracheal intubation (intubation model 7.0-7.5mm). Maintenance of anesthesia given weight-related propofol, fentanyl, atracurium. Intermittent positive pressure ventilation (IPPV) ventilation parameters to the Drager Fabius 2604100 anesthesia machine line is set to moisture amount (VT) 10ml/kg, respiratory frequency (f) = 10 bpm (Fio2) = 100% inspired oxygen concentration, respiratory ratio ( I: E) = 1:2, PEEP (PEEP) is 0. Phosphate Sodium treatment group was given sequence intubation Phosphate Sodium Creatine phosphate (trade name Wei-jia, Haikou Kellett Pharmaceutical Co., Ltd.) 1g dissolved in 100 ml of normal saline infusion, before anesthesia (h0 ) l hour after administration (h1), 2 hours after administration (h2) Determination of arterial blood gas analysis and ion Phosphate Sodium treatment group and the control group were taken. Japan Olympus1000 automatic biochemical analyzer, before anesthesia (h0), 1 hour after administration (h1), after administration of 24 hours (h2) treatment and control groups, blood samples were used by the Shanghai Biological Engineering Co., Ltd. dedicated control serum determination of serum creatine kinase brain isoenzyme (CK-BB). Before anesthesia (h0), 1 hour after dosing (H1), after administration of two hours (h2) the treatment group and the control group were respectively venous blood human γ-amino butyric acid (GABA) ELISA kit for determination of γ-amino butyric acid content. Each point in time values ??were expressed as mean ± standard deviation (x ± s). Results: The two groups of patients such as gender, age, weight, operation time, high blood pressure normal circumstances no special (P gt; 0.05). Perioperative arterial blood blood gas analysis, Sodium Phosphate treatment group compared with control group, blood oxygen pressure in the treatment group at various time points after administration has significantly increased, and the difference was statistically significant (P lt ; 0.05); 1 hour after the administration of the two groups of patients, and 24 hours after administration of creatine kinase brain isoenzyme (CK-BB) was significantly higher than the preoperative treatment group compared with the control group increased the apparent reduced, the difference was statistically significant (P lt; 0.05); 1 hour after administration and 2 hours after administration of the treatment group compared with the control group of γ-aminobutyric acid levels have significantly increased, and the difference was statistically significant ( P lt; 0.05); arterial blood test ion found Ca2 concentration at 1 hour after administration and 2 hours after administration plasma treatment group were significantly higher than that in the control group, the difference was statistically significant (P lt; 0.05); Na, K concentration no significant changes, the difference was not statistically significance (P gt; 0.05). Conclusion: Phosphate Sodium can increase blood oxygen pressure perioperative cerebral ischemia in elderly patients, inhibiting the release of excitatory amino acids, to promote the release of gamma-aminobutyric acid, raise creatine levels associated with ATP, or save energy ratio, promote the loss of cell repair and survival.
|