中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2014年
3期
30-31,32
,共3页
吸烟%冠状动脉旁路移植术%麻醉诱导%BIS
吸煙%冠狀動脈徬路移植術%痳醉誘導%BIS
흡연%관상동맥방로이식술%마취유도%BIS
Smoking%Coronary artery bypass grafting%Anesthesia induction%BIS
目的：探讨吸烟对冠状动脉旁路移植术患者麻醉诱导期脑电双频指数（BIS）和血流动力学的影响。方法：选取40例行冠脉搭桥手术患者，ASAⅡ~Ⅲ级，按随机数字表法分为吸烟组20例和未吸烟组20例。所有患者均使用咪唑安定、依托咪酯、异丙酚、舒芬太尼和维库溴铵进行麻醉诱导，记录插管前、插管即刻和插管后1、2、3 min的心率（HR）、平均动脉压（MAP）和BIS值。结果：两组诱导前的基础MAP和BIS的比较差异无统计学意义（P>0.05）；吸烟组的基础HR慢于未吸烟组。吸烟组气管插管即刻和气管插管后1、2 min的BIS值均高于未吸烟组（P<0.05）；与未吸烟组相比，吸烟组在气管插管即刻、插管后1、2 min HR和MAP升高更明显（P<0.05）。结论：吸烟影响冠状动脉旁路移植术麻醉诱导期的BIS，吸烟患者冠状动脉旁路移植手术麻醉诱导期血流动力学变化更加剧烈，更要注意保持血流动力学稳定，有效预防心肌缺血。
目的：探討吸煙對冠狀動脈徬路移植術患者痳醉誘導期腦電雙頻指數（BIS）和血流動力學的影響。方法：選取40例行冠脈搭橋手術患者，ASAⅡ~Ⅲ級，按隨機數字錶法分為吸煙組20例和未吸煙組20例。所有患者均使用咪唑安定、依託咪酯、異丙酚、舒芬太尼和維庫溴銨進行痳醉誘導，記錄插管前、插管即刻和插管後1、2、3 min的心率（HR）、平均動脈壓（MAP）和BIS值。結果：兩組誘導前的基礎MAP和BIS的比較差異無統計學意義（P>0.05）；吸煙組的基礎HR慢于未吸煙組。吸煙組氣管插管即刻和氣管插管後1、2 min的BIS值均高于未吸煙組（P<0.05）；與未吸煙組相比，吸煙組在氣管插管即刻、插管後1、2 min HR和MAP升高更明顯（P<0.05）。結論：吸煙影響冠狀動脈徬路移植術痳醉誘導期的BIS，吸煙患者冠狀動脈徬路移植手術痳醉誘導期血流動力學變化更加劇烈，更要註意保持血流動力學穩定，有效預防心肌缺血。
목적：탐토흡연대관상동맥방로이식술환자마취유도기뇌전쌍빈지수（BIS）화혈류동역학적영향。방법：선취40례행관맥탑교수술환자，ASAⅡ~Ⅲ급，안수궤수자표법분위흡연조20례화미흡연조20례。소유환자균사용미서안정、의탁미지、이병분、서분태니화유고추안진행마취유도，기록삽관전、삽관즉각화삽관후1、2、3 min적심솔（HR）、평균동맥압（MAP）화BIS치。결과：량조유도전적기출MAP화BIS적비교차이무통계학의의（P>0.05）；흡연조적기출HR만우미흡연조。흡연조기관삽관즉각화기관삽관후1、2 min적BIS치균고우미흡연조（P<0.05）；여미흡연조상비，흡연조재기관삽관즉각、삽관후1、2 min HR화MAP승고경명현（P<0.05）。결론：흡연영향관상동맥방로이식술마취유도기적BIS，흡연환자관상동맥방로이식수술마취유도기혈류동역학변화경가극렬，경요주의보지혈류동역학은정，유효예방심기결혈。
Objective:To observe the effects of smoking on bispectral index(BIS)and hemodynamics in coronary artery bypass grafting(CABG) patients during induction of anesthesia. Method:40 patients(ASAⅡ-Ⅲ) for CABG were divided into two groups according to random number table method:smokers(n=20)and non-smokers(n=20). All patients were using midazolam,etomidate,propofol,sufentanil and vecuronium for induction of anesthesia. Heart rate(HR),mean arterial pressure(MAP)and BIS were recorded at intubation immediately,before intubation,1min,2 min and 3min after intubation. Result:MAP and BIS before the basis of the two groups comparison differences had no statistical significance(P>0.05);The basis of HR in the smoking group was slower than the non-smoking group. Tracheal intubation and tracheal intubation after 1,2 min,BIS values of the smoking group were higher than the non-smoking group(P<0.05);Compared with the non-smoking group,during endotracheal intubation and after intubation 1,2 min,HR and MAP of the smoking group were increased more significantly(P<0.05).Conclusion:Smoking affects coronary artery bypass grafting anesthesia induction period of the BIS,smoking patients with coronary artery bypass graft surgery anesthesia induction period hemodynamic change is more intense,more attention should be paid to maintain hemodynamic stability,effective prevention of myocardial ischemia.
