| Objective:Hemodynamic parameters,cerebral oxygen metabolism related indexes and the content changes of nerve injury markers were detected in this study to evaluate the neuroprotective effects of low-dose norepinephrine combined with goal-directed fluid therapy guided by stroke volume variability in patients with cerebral revascularization.Methods:Forty patients who met the requirements of the trial and received elective cerebral revascularization were randomly divided into two groups（n=20）:goal-directed fluid therapy group（group G）and conventional fluid therapy group（group C）.Group G received goal-directed fluid therapy guided by stroke volume variability according to Flotrac/Vigileo monitoring system,group C received volumetric therapy performed with traditional infusion regimen,low-dose of norepinephrine(0.01-0.03μg·kg-1·min-1)were continuously pumped in both groups intraoperatively.Hemodynamic parameters,cerebral oxygen metabolism related indexes and the content changes of nerve injury markers such as NSE and S100βwere recorded.The fluid intake and output,complications and postoperative hospital stay of the two groups were recorded.The NIHSS scores of the patients were recorded.Results:1.Fluid intake and output:Compared with group C,the amount of crystalloid,colloid and total infusion in group G were significantly lower.（P<0.05）.2.HR:Compared with Ta and Tb,the HR of Tc-Tg in two groups were significantly lower,Compared with Tc,the HR of Td and Te in two groups were significantly lower,Compared with Td,the HR of Te in two groups were significantly lower（P<0.05）.3.MAP:Compared with Ta and Tb,the MAP of Tc-Te in two groups were significantly higher,Compared with Tf,the MAP of Tc and Te in two groups were significantly higher,Compared with Tg,the MAP of Tc-Te in two groups were significantly higher（P<0.05）.4.Sjv O2:Compared with group C,the Sjv O2 of T4 in group G was significantly higher（P<0.05）;Compared with T3,the Sjv O2 of T4 in two groups were significantly higher（P<0.05）.5.CERO2:Compared with group C,the CERO2 of T4 in group G was significantly lower（P<0.05）.Compared with T3,the CERO2 of T2 and T4 in two groups were significantly lower.（P<0.05）.6.S100βprotein concentration and NSE:Compared with group C,the S100βprotein concentration and NSE of T4in group G were significantly lower（P<0.05）.7.NIHSS score:Compared with group C,the NIHSS score of d7 in group G was significantly lower（P<0.05）;Compared with d0,the NIHSS score of d3and d7 in two groups were significantly lower（P<0.05）.Conclusions:Low-dose of norepinephrine combined with goal-directed fluid therapy can reduce the total amount of intraoperative fluid,optimize the oxygen supply to the brain and protect the brain function on patients with cerebral revascularization. |
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