中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
30期
1-4
,共4页
二异丙酚%颅内动脉瘤%靶控输注%麻醉诱导%介入治疗
二異丙酚%顱內動脈瘤%靶控輸註%痳醉誘導%介入治療
이이병분%로내동맥류%파공수주%마취유도%개입치료
Propofol%Intracranial aneurysm%Target controlled Infusion%Anesthesia induction%Interventional therapy
目的 观察丙泊酚目标靶控输注用于颅内动脉瘤介入治疗麻醉诱导过程中对血流动力学的影响.方法 择期行颅内动脉瘤介入治疗患者90例,按随机数字表法分为三组:对照组(C组)、血浆药物浓度靶控输注组(P组)和效应室药物浓度靶控输注组(E组),每组30例.C组采用丙泊酚2 mg/kg单次静脉推注;P组设定丙泊酚血浆靶浓度为4μg/ml;E组设定丙泊酚效应室靶浓度为4 μg/m],三组均采用瑞芬太尼浓度为4 ng/ml的血浆靶控输注,静脉推注顺阿曲库铵0.2 mg/kg.持续监测呼气末二氧化碳分压、脑电双频指数、平均动脉压(MAP)、心率(HR)、心电图、脉搏血氧饱和度及生命体征.记录各组患者诱导前(T0)、插管即刻(T1)、插管后1 min (T2)、3 min(T3)、5 min(T4)、10 min(T5)的MAP和HR,记录血流动力学异常发生率及血管活性药物使用情况.结果 三组T0时MAP及HR比较差异无统计学意义(P＞0.05).三组T1时MAP及HR均显著低于本组T0,差异有统计学意义(P＜0.05);P组T1时MAP及HR显著低于E组和C组,差异有统计学意义(P＜0.05).P组使用血管活性药物例数显著低于C组[6.7％(2/30)比40.0％(12/30)],差异有统计学意义(P＜0.01).结论 丙泊酚血浆药物浓度作为目标靶控输注浓度更适合颅内动脉瘤介入手术患者的麻醉诱导.
目的 觀察丙泊酚目標靶控輸註用于顱內動脈瘤介入治療痳醉誘導過程中對血流動力學的影響.方法 擇期行顱內動脈瘤介入治療患者90例,按隨機數字錶法分為三組:對照組(C組)、血漿藥物濃度靶控輸註組(P組)和效應室藥物濃度靶控輸註組(E組),每組30例.C組採用丙泊酚2 mg/kg單次靜脈推註;P組設定丙泊酚血漿靶濃度為4μg/ml;E組設定丙泊酚效應室靶濃度為4 μg/m],三組均採用瑞芬太尼濃度為4 ng/ml的血漿靶控輸註,靜脈推註順阿麯庫銨0.2 mg/kg.持續鑑測呼氣末二氧化碳分壓、腦電雙頻指數、平均動脈壓(MAP)、心率(HR)、心電圖、脈搏血氧飽和度及生命體徵.記錄各組患者誘導前(T0)、插管即刻(T1)、插管後1 min (T2)、3 min(T3)、5 min(T4)、10 min(T5)的MAP和HR,記錄血流動力學異常髮生率及血管活性藥物使用情況.結果 三組T0時MAP及HR比較差異無統計學意義(P＞0.05).三組T1時MAP及HR均顯著低于本組T0,差異有統計學意義(P＜0.05);P組T1時MAP及HR顯著低于E組和C組,差異有統計學意義(P＜0.05).P組使用血管活性藥物例數顯著低于C組[6.7％(2/30)比40.0％(12/30)],差異有統計學意義(P＜0.01).結論 丙泊酚血漿藥物濃度作為目標靶控輸註濃度更適閤顱內動脈瘤介入手術患者的痳醉誘導.
목적 관찰병박분목표파공수주용우로내동맥류개입치료마취유도과정중대혈류동역학적영향.방법 택기행로내동맥류개입치료환자90례,안수궤수자표법분위삼조:대조조(C조)、혈장약물농도파공수주조(P조)화효응실약물농도파공수주조(E조),매조30례.C조채용병박분2 mg/kg단차정맥추주;P조설정병박분혈장파농도위4μg/ml;E조설정병박분효응실파농도위4 μg/m],삼조균채용서분태니농도위4 ng/ml적혈장파공수주,정맥추주순아곡고안0.2 mg/kg.지속감측호기말이양화탄분압、뇌전쌍빈지수、평균동맥압(MAP)、심솔(HR)、심전도、맥박혈양포화도급생명체정.기록각조환자유도전(T0)、삽관즉각(T1)、삽관후1 min (T2)、3 min(T3)、5 min(T4)、10 min(T5)적MAP화HR,기록혈류동역학이상발생솔급혈관활성약물사용정황.결과 삼조T0시MAP급HR비교차이무통계학의의(P＞0.05).삼조T1시MAP급HR균현저저우본조T0,차이유통계학의의(P＜0.05);P조T1시MAP급HR현저저우E조화C조,차이유통계학의의(P＜0.05).P조사용혈관활성약물례수현저저우C조[6.7％(2/30)비40.0％(12/30)],차이유통계학의의(P＜0.01).결론 병박분혈장약물농도작위목표파공수주농도경괄합로내동맥류개입수술환자적마취유도.
Objective To observe the effects of target-controlled infusion ofpropofol on hemodynamics during anesthesia induction in intracranial aneurysms interventional treatment.Methods Ninety patients in intracranial aneurysms interventional treatment were divided into three groups by random digits table method with 30 cases each:control group (group C),plasma drug concentration in target controlled infusion group (group P) and effect of chamber drug concentration in target controlled infusion group (group E).The induction of anesthesia:patients in group C were single intravenous injected with propofol of 2 mg/kg; patients in group P were set target plasma concentration of propofol with 4 μ g/ml.Patients in group E were set the effect target concentration of propofol with 4 μ g/ml.Three groups were set the concentration of remifentanil 4 ng/ml with plasma controlled infusion,and cisatracurium was injected with 0.2 mg/kg.Electrocardiogram,mean arterial pressure (MAP),heart rate (HR),end-tidal pressure of carbon dioxide,bispectral index,pulse oxygen saturation were continuously monitored.Before the time of induction (T0),immediately before intubation (T1),after intubation 1 min (T2),3 min (T3),5 min (T4),10 min (T5),arterial pressure and HR were recorded and the number of using vasoactive drugs were recorded.Results The level of MAP and HR among three groups at T0 had no significant difference (P ＞ 0.05).The level ofMAP and HR in three groups at T1 was significantly lower than that at T0.(P ＜ 0.05).The level of MAP and HR in group P was lower than that in group E and group C,and there was significant difference (P ＜ 0.05).The incidence of using vasoactive agen in group P was significantly lower than that in group C [6.7％(2/30) vs.40.0％ (12/30)],and there was significant difference (P ＜0.01).Conclusion Hemodynamics is relatively stable during anesthesia induction using plasma target controlled infusion with propofol in patients undergoing interventional therapy for intracranial aneurysm.
