目的 研究丙泊酚对重型颅脑损伤患者血清S100B蛋白浓度的影响,评价丙泊酚脑保护作用.方法 40例重型颅脑损伤患者按就诊顺序随机分为常规治疗组、丙泊酚组,各20例.各组患者均行急诊开颅手术,常规治疗组在手术前后只给予各项常规治疗；丙泊酚组在常规治疗基础上,手术后当天开始靶控输注丙泊酚,先静脉注射丙泊酚1.5 mg/kg行镇静诱导,然后改用微量注射泵持续注射丙泊酚,根据不同镇静程度用药量为0.5～4.0 mg/(kg·h),应用丙泊酚时间至少到手术后第3天.分别测定2组入院时以及手术后第1、3、5、7天的血清S100B蛋白水平.结果 手术后丙泊酚组第1、3、5、7天血清S100B浓度分别为(3.19±0.25)、(2.48±0.23)、(2.22±0.27)、(2.00±0.21) μg/L,均低于常规治疗组[(3.23±0.20)、(2.89±0.28)、(2.55±0.26)、(2.30 ±0.20) μg/L](均P＜0.05).结论 丙泊酚静脉靶控输注能有效降低重型颅脑损伤血清S100B蛋白浓度,具有脑保护作用.%Objective To investigate the effect of target-controlled propofol on serum level of S100B protein in patients with severe head injury.Methods Forty patients with severe head injury were randomly divided into routine treatment group and propofo group with twenty cases in each group.All patients had the emergency craniotomy operation.The routine treatment group was only given routine therapy before and after operation,including sedation,dehydration,hemostatic,inflammatory,neurotrophy and supportive therapy; the propofol group was given the basis treatment plus the target-controlled propofol for at least three days after operation.The serum S100B levels were measured before operation,the 1 d,3 d,5 d,7 d after operation.Results The S100B levels in propofo group were significantly decreased in 1 d [(3.19 ±0.25)μg/L],3 d[(2.48 ±0.23)μg/L],5 d [(2.22 ± 0.27) μg/L] and 7 d [(2.00 ± 0.21) μg/L] after operation compared with routine treatment group [(3.23 ±0.20) μg/L,(2.89 ±0.28)μg/L,(2.55 ± 0.26) μg/L,(2.30±0.20)μg/L] (all P＜0.05).Conclusions Propofol of target controlled can effectively reduce the serum S100B levels in severe craniocerebral injury patients after the operation and protect neurocytes.
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