CAJ | 학술논문

目的评价洗入高浓度七氟醚麻醉诱导对低龄婴儿心功能的影响.方法择期行体表血管瘤切除术婴儿,28 ～ 60 d龄,ASA分级Ⅰ级,按体重3.0～3.4 kg、3.5 ～ 3.9 kg、4.0～4.4 kg、4.5～4.9kg、5.0～5.4kg、5.5～5.9kg、6.0～6.4kg、6.5～6.9kg分为8个区组,每一区组3例患儿,采用随机数字表法,将其随机分为3组(n=8):吸入6％、7％和8％七氟醚麻醉诱导组(S1组、S2组和S3组).吸入七氟醚进行麻醉诱导,分别于吸入七氟醚前(基础状态,T1)和吸入七氟醚4 min时(T2)采用心脏超声多普勒技术测定每搏量(SV)、左心室舒张末期容积(LVEDV)、射血分数(EF)、每搏指数(SI)、心率(HR)、心输出量(CO)、心指数(CI)、二尖瓣环后间隔侧左心室快速充盈期心肌组织运动峰速度(Ea)、二尖瓣环后间隔侧左心室在心房收缩期心肌组织运动峰速度(Aa)、Ea与Aa的比值(Ea/Aa)、二尖瓣环后间隔侧收缩期心肌组织运动峰速度(Sa)和Tei指数.结果与T1时比较,3组T2时SV、EF、S1 、Ea/Aa和Tei指数均升高,HR、Ea、Aa和Sa降低(P＜0.05),而LVEDV、CO和CI差异无统计学意义(P＞0.05)；与S1组比较,S2组和S3组Tei指数升高(P＜0.05),其余指标差异无统计学意义(P＞0.05)；S2组和S3组心功能指标差异无统计学意义(P＞0.05).结论洗入6％、7％、8％七氟醚麻醉诱导对低龄婴儿心功能无明显影响,3种浓度七氟醚均可用于临床.
목적 평개세입고농도칠불미마취유도대저령영인심공능적영향.방법 택기행체표혈관류절제술영인,28 ～ 60 d령,ASA분급Ⅰ급,안체중3.0～3.4 kg、3.5 ～ 3.9 kg、4.0～4.4 kg、4.5～4.9kg、5.0～5.4kg、5.5～5.9kg、6.0～6.4kg、6.5～6.9kg분위8개구조,매일구조3례환인,채용수궤수자표법,장기수궤분위3조(n=8):흡입6％、7％화8％칠불미마취유도조(S1조、S2조화S3조).흡입칠불미진행마취유도,분별우흡입칠불미전(기출상태,T1)화흡입칠불미4 min시(T2)채용심장초성다보륵기술측정매박량(SV)、좌심실서장말기용적(LVEDV)、사혈분수(EF)、매박지수(SI)、심솔(HR)、심수출량(CO)、심지수(CI)、이첨판배후간격측좌심실쾌속충영기심기조직운동봉속도(Ea)、이첨판배후간격측좌심실재심방수축기심기조직운동봉속도(Aa)、Ea여Aa적비치(Ea/Aa)、이첨판배후간격측수축기심기조직운동봉속도(Sa)화Tei지수.결과 여T1시비교,3조T2시SV、EF、S1 、Ea/Aa화Tei지수균승고,HR、Ea、Aa화Sa강저(P＜0.05),이LVEDV、CO화CI차이무통계학의의(P＞0.05)；여S1조비교,S2조화S3조Tei지수승고(P＜0.05),기여지표차이무통계학의의(P＞0.05)；S2조화S3조심공능지표차이무통계학의의(P＞0.05).결론 세입6％、7％、8％칠불미마취유도대저령영인심공능무명현영향,3충농도칠불미균가용우림상.
Objective To evaluate the effect of the high concentration of sevoflurane wash-in in induction of anesthesia on the cardiac function in young infants.Methods ASA Ⅰ young infants,aged 28-60 days,undergoing resection of hemangioma on body surface under general anesthesia,were studied.According to the principle of randomized block design,8 blocks were designed based on the body weight (3.0-3.4 kg,3.5-3.9 g,4.0-4.4 kg,4.5-4.9 kg,5.0-5.4 kg,5.5-5.9 kg,6.0-6.4 kg,6.5-6.9 kg),with 3 infants in each block.The infants were randomly divided into 3 groups (n =8 each):anesthesia induction with 6％,7％ and 8％ sevoflurane groups (groups S1-3).In groups S1-3,the infants inhaled 6 ％,7 ％ and 8 ％ sevoflurane respectively for induction of anesthesia.Transthoracic echocardiographic examinations were performed before sevoflurane inhalation (baseline,T1) and at 4 min of sevoflurane inhalation (T2) to record the stroke volume (SV),left ventricle end-diastolic volume (LVEDV),ejection fraction (EF),stroke volume index (SI),heart rate (HR),cardiac output (CO),cardiac index (CI),peak early diastolic velocity of mitral annulus (Ea),peak late diastolic velocity of mitral annulus (Aa),peak systolic velocity of mitral annulus (Sa),and Tei index.The mitral annulus poteroseptal Ea/Aa (Ea/Aa) was calculated.Results Compared with the baseline value,SV,EF,SI,Ea/Aa and Tei index were significandy increased,HR,Sa,Ea and Aa were significantly decreased (P ＜ 0.05),and no significant change was found in LVEDV,CO and CI at 4 min of sevoflurane inhalation in groups S1-3 (P ＞ 0.05).Tei index was significantly higher in groups S2.3 than in group S1 (P ＜ 0.05).There was no significant difference in the parameters of cardiac function between group S2 and group S3 (P ＞ 0.05).Conclusion 6 ％,7 ％ and 8 ％ sevoflurane wash-in in induction of anesthesia exert no effect on the cardiac function in young infants,and the 3 concentrations can be recommended for clinical use.