目的：探讨高渗氯化钠羟乙基淀粉对癫痫手术患者脑组织含水量、颅内压以及脑组织水通道蛋白4和 N－甲基－D－天冬氨酸受体1表达的影响。方法选择2013年1月至2014年4月四川省肿瘤医院确诊癫痫拟行癫痫灶切除术的患者48例，依据随机数字表法分为4组：A 组（6％中分子羟乙基淀粉，晶胶比0∶1）、B 组（6％中分子右旋糖酐，晶胶比0∶1）、C 组（6％中分子羟乙基淀粉，晶胶比1∶1）、D 组（6％中分子右旋糖酐，晶胶比1∶1），各12例。分析4组患者术中颅内压及切除脑组织中的脑含水量、水通道蛋白4和 N－甲基－D－天冬氨酸受体1的表达情况。结果4组间颅内压、脑组织含水量、水通道蛋白4吸光度值、N－甲基－D－天冬氨酸受体1的吸光度值比较差异有统计学意义（P ＜0.05），其中 B 组各指标均高于其他3组，其次是 A 组高于 C、D 组，且 D 组高于 C 组。结论癫痫灶切除术的围术期液体应用中，6％中分子羟乙基淀粉与晶胶比1∶1的配合使用的补液最具有临床应用价值。%Objective To investigate the influence of hypertonic sodium chloride hydroxyethyl starch on brain tissue water content,intracranial pressure,expression of aquaporin-4 and N-methyl-D-aspartate receptor 1 of epilepsy patients undergoing brain surgery.Methods A total of 48 epilepsy patients undergoing epilep-tic foci resection in Sichuan Provincial Tumor Hospital from Jan.2013 to Apr.2014 were included in the study,in were randomly divided into four groups according to random-number table method to receive differ-ent colloids during operation (6% hydroxyethyl starch molecules,6% dextran molecules) and crystal-glue ratio(0∶1,1∶1):group A(6% medium molecule hydroxyethyl starch,the crystal glue ratio 0 ∶1),group B (6% medium molecule dextran,crystal glue ratio 0∶1),group C (6% medium molecule hydroxyethyl starch, crystal glue ratio 1 ∶1),group D (6% medium molecule dextran,crystal glue ratio 1 ∶1).The intracranial pressure,cerebral water content,expression of aquaporin-4 and N-methyl-D-aspartate receptor-1 in brain tis-sue of the four groups were compared.Results The difference on each index was statistically significant among the four groups(intracranial pressure,brain water content,aquaporin 4 absorbance value,N-methyl-D-aspartate receptor-1 absorbance value)(P <0.05),among which the indexes of group B were higher than the other three groups,followed by the group A,and then group D.Conclusion In perioperative fluid applica-tion during epileptic resection, the liquid which contains 6% medium molecule hydroxyethyl starch with the crystal glue ratio of 1∶1 has the highest clinical applicative value .
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