国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2012年
9期
607-609,641
,共4页
姜黎珊%张冯江%马雷雷%孙凯%严敏
薑黎珊%張馮江%馬雷雷%孫凱%嚴敏
강려산%장풍강%마뢰뢰%손개%엄민
灌注指数%Masimo set技术%体动反应%异丙酚%人工流产
灌註指數%Masimo set技術%體動反應%異丙酚%人工流產
관주지수%Masimo set기술%체동반응%이병분%인공유산
Perfusion index%Masimo set technology%Body movement%Propofol%Induced abortion
目的 通过对无痛人工流产术中体动反应进行多因素的回归分析,探讨灌注指数在静脉麻醉中预测体动反应的作用.方法 68例美国麻醉医师协会(ASA)分级Ⅰ级、年龄20岁～30岁、体重45 kg～60 kg接受无痛人工流产术的孕妇,麻醉给予异丙酚1.8 mg/kg和氯胺酮0.5 mg/kg静脉注射,患者安静3 min后的测量值(T1)作为基础值,给药后3min时(T2)的测量值作为麻醉诱导后的值,记录这两个时刻的末梢灌注指数(perfusion index,Pl)、脑电双频指数(bispectral index,BIS)、心率(HR)、脉搏血氧饱和度(SpO2)、收缩压(SBP)、舒张压(DBP).根据术中孕妇是否有体动反应,将患者分为体动组和非体动组.结果 本研究中有32.8％的孕妇在术中出现了体动反应.两组的年龄、体重、孕周、人工流产史、生产史、T1与T2的血压、心率和BIS值的差异均无统计学意义(P＞0.05).与无体动组比较,体动组的T1和T2时刻的PI值[分别为(0.39±0.16)、(0.99±0.40)]以及它们的比值[PI(T2/T1)](2.91±1.41)均下降(P＜0.05).应用二分变量logistic回归分析显示T2时的PI和PI(T2/T1)可以独立地预测体动反应.受试者工作曲线分析显示,以T2时的PI预测无体动反应的发生,曲线下面积(areas under curves,AUC)为0.897,以PI(T2/T1)预测无体动反应的发生,AUC为0.857.结论 测量PI值有助于监控患者的麻醉状态,麻醉诱导后的PI以及PI(T2/T1)可能是无痛人工流产术中体动反应的有效预测指标.
目的 通過對無痛人工流產術中體動反應進行多因素的迴歸分析,探討灌註指數在靜脈痳醉中預測體動反應的作用.方法 68例美國痳醉醫師協會(ASA)分級Ⅰ級、年齡20歲～30歲、體重45 kg～60 kg接受無痛人工流產術的孕婦,痳醉給予異丙酚1.8 mg/kg和氯胺酮0.5 mg/kg靜脈註射,患者安靜3 min後的測量值(T1)作為基礎值,給藥後3min時(T2)的測量值作為痳醉誘導後的值,記錄這兩箇時刻的末梢灌註指數(perfusion index,Pl)、腦電雙頻指數(bispectral index,BIS)、心率(HR)、脈搏血氧飽和度(SpO2)、收縮壓(SBP)、舒張壓(DBP).根據術中孕婦是否有體動反應,將患者分為體動組和非體動組.結果 本研究中有32.8％的孕婦在術中齣現瞭體動反應.兩組的年齡、體重、孕週、人工流產史、生產史、T1與T2的血壓、心率和BIS值的差異均無統計學意義(P＞0.05).與無體動組比較,體動組的T1和T2時刻的PI值[分彆為(0.39±0.16)、(0.99±0.40)]以及它們的比值[PI(T2/T1)](2.91±1.41)均下降(P＜0.05).應用二分變量logistic迴歸分析顯示T2時的PI和PI(T2/T1)可以獨立地預測體動反應.受試者工作麯線分析顯示,以T2時的PI預測無體動反應的髮生,麯線下麵積(areas under curves,AUC)為0.897,以PI(T2/T1)預測無體動反應的髮生,AUC為0.857.結論 測量PI值有助于鑑控患者的痳醉狀態,痳醉誘導後的PI以及PI(T2/T1)可能是無痛人工流產術中體動反應的有效預測指標.
목적 통과대무통인공유산술중체동반응진행다인소적회귀분석,탐토관주지수재정맥마취중예측체동반응적작용.방법 68례미국마취의사협회(ASA)분급Ⅰ급、년령20세～30세、체중45 kg～60 kg접수무통인공유산술적잉부,마취급여이병분1.8 mg/kg화록알동0.5 mg/kg정맥주사,환자안정3 min후적측량치(T1)작위기출치,급약후3min시(T2)적측량치작위마취유도후적치,기록저량개시각적말소관주지수(perfusion index,Pl)、뇌전쌍빈지수(bispectral index,BIS)、심솔(HR)、맥박혈양포화도(SpO2)、수축압(SBP)、서장압(DBP).근거술중잉부시부유체동반응,장환자분위체동조화비체동조.결과 본연구중유32.8％적잉부재술중출현료체동반응.량조적년령、체중、잉주、인공유산사、생산사、T1여T2적혈압、심솔화BIS치적차이균무통계학의의(P＞0.05).여무체동조비교,체동조적T1화T2시각적PI치[분별위(0.39±0.16)、(0.99±0.40)]이급타문적비치[PI(T2/T1)](2.91±1.41)균하강(P＜0.05).응용이분변량logistic회귀분석현시T2시적PI화PI(T2/T1)가이독입지예측체동반응.수시자공작곡선분석현시,이T2시적PI예측무체동반응적발생,곡선하면적(areas under curves,AUC)위0.897,이PI(T2/T1)예측무체동반응적발생,AUC위0.857.결론 측량PI치유조우감공환자적마취상태,마취유도후적PI이급PI(T2/T1)가능시무통인공유산술중체동반응적유효예측지표.
Objective To investigate the role of the perfusion index (PI) in predicting body movement during indolent induced abortion with intravenous anesthesia by multivariate logistic analysis.Methods 68 early pregnancy women,ASA I,aged 20 y-30 y,weighed 45 kg-60 kg,were subjected to indolent induced abortion with 1.8 mg/kg propofol and 0.5 mg/kg ketamine in this study and allocated into moving group and non-moving group based on whether body movement responses occurred during the surgical procedures.The PI,bispectral index (BIS),HR,SpO2 and blood pressure were monitored before induction of anesthesia (T1) and 3 min after induction (T2).Results 32.8％ of the pregnant women took place body movement during the procedures.There were no significant difference between two groups in age,weight,gestational weeks,the history of induced abortion or labor,BIS index,blood pressure and HR at T1 and T2 (P＞0.05).Compared with non-moving group,the pregnant women in moving group showed lower PI at T1 and T2 (0.39±0.16,0.99±0.40) and the ratio of PI at T2/T1 [PI (T2/T1)] (2.91± 1.41 ) (P＜0.05).Logistic analysis showed that PI at T2 and PI (T2/Tt) were independent factors for predicting body movement during the induced abortion.According to the analysis of receivers operating characteristic curve,using Pt at T2 and PI (T2/T1) for predicting body movement,the areas under curves(AUC) were respectively 0.897 and 0.857.Conclusions Measurement of PI is helpful for monitoring anesthesia,and PI at T2 as well PI(T2/T1) might be effective in predicting body movement during the induced abortion.
