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为了探究不同方式靶控输注丙泊酚对高龄患者诱导期血流动力学的影响,本研究选取我院2015年1月至2016年1月收治的80例行腹部手术患者作为研究对象,按照简单随机法将患者分为Ⅰ组(进行血浆靶控输注丙泊酚)、Ⅱ组(进行效应室靶控输注丙泊酚)、Ⅲ组(进行梯度血浆靶控输注丙泊酚)、Ⅳ组(进行梯度效应室靶控输注丙泊酚)。通过比较4组患者AAI值、心排血量、心排指数、外周血管阻力、平均动脉压及心率的变化,我们发现4组患者经丙泊酚诱导麻醉后,AAI值、心排指数、外周血管阻力、平均动脉压检测均低于麻醉前,心率明显高于麻醉诱导前(p<0.05);而在T1时刻,Ⅱ组患者AAI值明显低于Ⅰ组、Ⅲ组、Ⅳ组患者(p<0.05);在T2、T3、T4时刻各组心率、外周血管阻力、平均动脉压比较无明显差异(p>0.05);T1时刻Ⅲ组、Ⅳ组患者心率明显低于Ⅰ组、Ⅱ组(p<0.05);而Ⅳ组患者心排指数、外周血管阻力、平均动脉压下降幅度明显低于Ⅰ组、Ⅱ组、Ⅲ组患者(p<0.05)。研究表明,对高龄患者进行麻醉时,采用梯度效应室靶控输注丙泊酚进行诱导麻醉,不仅不影响麻醉效果,同时可减轻对患者循环系统的影响,过程平稳,值得广泛应用于临床。
Abstract：In order to investigate the effects of different target controlled infusion of propofol on hemodynamics in elderly patients, this research selected 80 cases of abdominal surgery patients who were treated in our hospital from January 2015 to January 2016, and divided them into groupⅠ(plasma TCI propofol), groupⅡ(the effect of chamber target controlled infusion of propofol), Group Ⅲ(the gradient of plasma target controlled infusion of propofol),group Ⅳ(gradient effect site target controlled infusion of propofol) according to the simple random method. By comparing the changes of AAI, cardiac output, cardiac index, peripheral resistance, mean arterial pressure and heart rate among four groups, we found that after propofol anesthesia, AAI, cardiac index, peripheral resistance, and mean arterial pressure of four groups were lower than those before anesthesia, and heart rate was significantly higher than that before induction of anesthesia(p<0.05); in T1, AAI value of the patients in group Ⅱ was significantly lower than that of groupⅠ, group Ⅲand group Ⅳ(p>0.05); in T2, T3, T4, the heart rate, peripheral resistance,and mean arterial pressure had no significant difference(p>0.05); in T1, the heart rates of patients in group Ⅲand Ⅳ groups were significantly lower than those of groupⅠ and group Ⅱ(p<0.05); the cardiac index, peripheral resistance, and mean arterial pressure of patients in group Ⅳ decreased significantly less than groupⅠ, group Ⅱ and group Ⅲ(p<0.05). These results indicated that when anesthesia was given to the elderly patients, the induction of anesthesia carried by the gradient of plasma target controlled infusion of propofol, not only had no influence on the anesthetic effect, but could reduce the impact on the circulatory system in patients with stable process, and it would be worthy to be widely used in clinical application.
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基本信息:
DOI：10.13417/j.gab.037.000115
中图分类号:R614
引用信息:
[1]康振明,曾景阳,谢文钦,等.不同方式靶控输注丙泊酚对高龄患者诱导期血流动力学的影响[J].基因组学与应用生物学,2018,37(01):115-122.DOI:10.13417/j.gab.037.000115.
基金信息:
福建省泉州市社会发展科技计划项目(No:2013Z072)资助
2018-01-25
2018-01-25