CAJ | 학술논문

目的：探讨依托咪酯乳剂联合地佐辛在心脏病病人的无痛人流中应用的临床效果。方法选择接受无痛人工流产的心脏病病人60例，随机法分为A、B、C三组，每组各20例。 A组采用依托咪酯乳剂＋地佐辛麻醉；B组采用丙泊酚＋地佐辛麻醉；C组采用依托咪酯乳剂＋芬太尼麻醉，记录麻醉前（T1）、注射依托咪酯乳剂和丙泊酚后1 min（T2）、手术开始后1 min（T3）和3 min（T4）、手术结束（T5）时血压、心率、脉搏、氧饱和度；观察麻醉效果和麻醉恢复情况，记录各种不良反应。结果 T2时A、B两组患者比较，A组SBp、DBp、MAp、HR、SpO2下降幅度小于B组，差异有统计学意义（P＜0．01）；T2时A、C两组患者比较，两组患者的SBp、DBp、MAp、HR下降幅度差异无统计学意义（P＞0．05），A组SpO2下降幅度小于B组，差异有统计学意义（ P＜0．01）；三组患者麻醉效果、麻醉恢复情况无明显差别，不良反应统计中A组出现麻醉药物注射痛较B组少及A组出现肌震颤较B组多，差异有统计学意义（P＜0．01）。结论依托咪酯乳剂联合地佐辛麻醉对呼吸、循环无明显抑制，起效快，代谢迅速、苏醒质量好和不良反应少，更适用于心脏病病人的无痛人流。
목적：탐토의탁미지유제연합지좌신재심장병병인적무통인류중응용적림상효과。방법선택접수무통인공유산적심장병병인60례，수궤법분위A、B、C삼조，매조각20례。 A조채용의탁미지유제＋지좌신마취；B조채용병박분＋지좌신마취；C조채용의탁미지유제＋분태니마취，기록마취전（T1）、주사의탁미지유제화병박분후1 min（T2）、수술개시후1 min（T3）화3 min（T4）、수술결속（T5）시혈압、심솔、맥박、양포화도；관찰마취효과화마취회복정황，기록각충불량반응。결과 T2시A、B량조환자비교，A조SBp、DBp、MAp、HR、SpO2하강폭도소우B조，차이유통계학의의（P＜0．01）；T2시A、C량조환자비교，량조환자적SBp、DBp、MAp、HR하강폭도차이무통계학의의（P＞0．05），A조SpO2하강폭도소우B조，차이유통계학의의（ P＜0．01）；삼조환자마취효과、마취회복정황무명현차별，불량반응통계중A조출현마취약물주사통교B조소급A조출현기진전교B조다，차이유통계학의의（P＜0．01）。결론의탁미지유제연합지좌신마취대호흡、순배무명현억제，기효쾌，대사신속、소성질량호화불량반응소，경괄용우심장병병인적무통인류。
Objective To explore clinical effects of etomidate emulsion combined with dezocine in painless abortion for heart disease patients.Methods Sixty heart disease patients received painless abortion were randomly divided into group A(etomidate emulsion combined with dezocine,n=20),group B(propofol combined with dezocine,n=20) and group C(etomidate emulsion combined with fentanyl,n=20).BP、HR、P、SpO2 were recorded before anesthesia(T1), 1min after injection of etomidate and propofol(T2),1min(T3) and 3min(T4) after operation, at the end of the operation ( T5 ) .Observed the effect of anesthesia and anesthesia recovery, record adverse reactions of various.Results The SBP, DBP, MAP, HR, SpO2 of group A were decreased less than group B at T2, the differences were statistically significant (P<0.01).The decline of the SBP, DBP, MAP, HR were notsignificant difference between group A and group C at T2(P>0.05).The decrease of SpO2 in group A were less than group B, the difference was statistically significant (P<0.01).There were no statistically significant difference of anesthesia effect and recovery among the three groups.The anesthesia drug injection pain of group A less than that of group B,and the muscle tremor of group A more than that of group B, the differences were statistically significant ( P <0.01 ) . Conclusions For no significant inhibition on circulation and respiration,rapid action, rapid metabolism, good recoveryquality and less adverse reaction, etomidate emulsion combined with dezocine is better for heart disease patients in painless abortion.