CAJ | 학술논문

目的：通过观察靶控输注等效剂量的丙泊酚或依托咪酯对患者血液动力学的影响，了解各药物的临床效应，为临床麻醉合理用药提供依据。方法择期全麻下行外科手术患者60例，ASAⅠ~Ⅱ级，年龄（20~60）岁，分为丙泊酚组（P组，n=30），依托咪酯组（E组， n=30）。麻醉诱导前分别靶控输注两种药物，两组患者药物浓度为靶控输注等效剂量下的血药浓度。P组丙泊酚血浆靶浓度为2μg/mL， E组依托咪酯血浆靶浓度为0.3μg/mL。记录诱导前两组基础值（T0），输注后1min（T1）、3min（T2）、7min（T3）、10min（T4）时的HR、MAP、CO、SV、SVR。结果与T0比较，P组患者在靶控输注后HR、MAP明显降低（P<0.05），E组患者在靶控输注后HR、MAP有所降低，但差异无统计学意义；P组较E组在T3、T4时HR、MAP降低明显（P<0.05）；在T3、T4时，P组CO、SV、SVR与E组相比差异有统计学意义，且P组CO、SV、SVR总体趋势明显低于E组（P<0.05）。结论靶控输注依托咪酯用于全麻诱导对血液动力学的影响较丙泊酚轻微，麻醉诱导使用依托咪酯能够起到稳定心血管系统功能和降低麻醉危险性的效果。
목적：통과관찰파공수주등효제량적병박분혹의탁미지대환자혈액동역학적영향，료해각약물적림상효응，위림상마취합리용약제공의거。방법택기전마하행외과수술환자60례，ASAⅠ~Ⅱ급，년령（20~60）세，분위병박분조（P조，n=30），의탁미지조（E조， n=30）。마취유도전분별파공수주량충약물，량조환자약물농도위파공수주등효제량하적혈약농도。P조병박분혈장파농도위2μg/mL， E조의탁미지혈장파농도위0.3μg/mL。기록유도전량조기출치（T0），수주후1min（T1）、3min（T2）、7min（T3）、10min（T4）시적HR、MAP、CO、SV、SVR。결과여T0비교，P조환자재파공수주후HR、MAP명현강저（P<0.05），E조환자재파공수주후HR、MAP유소강저，단차이무통계학의의；P조교E조재T3、T4시HR、MAP강저명현（P<0.05）；재T3、T4시，P조CO、SV、SVR여E조상비차이유통계학의의，차P조CO、SV、SVR총체추세명현저우E조（P<0.05）。결론파공수주의탁미지용우전마유도대혈액동역학적영향교병박분경미，마취유도사용의탁미지능구기도은정심혈관계통공능화강저마취위험성적효과。
Objective?The?purpose?of?this?study?is?to?explore?the?evidence?for?the?suitability?of?different?general?anesthesia?inductions?in?clinic.?The?evidences?are?obtained?by?the?observation?of?the?effects?on?hemodynamic?parameters?using?target?controlled?infusion(TCI)anesthesia?with?propofol?and?etomidate.?Methods?60?patients?under?general?anaesthesia?were?enrolled,?ASA?ⅠorⅡ,?aged?20-60?years?old,?who?were?divide?into?2?groups,?group?P?number?of 30, group E number of 30. Use propofol TCI on patients in group P(blood target density 2μg/mL). For patients in group E, use etomidate TCI with blood target density 0.3μg/mL. First record the original index from two groups before TCI as T0,?and?then?record?HR,MAP,CO,SV,SVR?index?from?two?groups?at?1?min(T1),?3?min(T2),?7?min?(T3),?10?min(T4)after?TCI.?Results?Compared?to?T0, HR and MAP were signiifcantly decreased after the anesthesia induction for?patients?in?group?P(P<0.05), HR and MAP were decreased after the anesthesia induction for patients in group, but no statistically signiifcant difference. Compared?to?group?E,?HR?and?MAP?were?significantly?decreased?at?T3?and?T4(P<0.05).?Compared?to?group?E,?the?changes?on?CO,SV?and?SVR?have?statistically signiifcant difference for patients in group P at T3?and?T4,?and?CO,SV?and?SVR?in?group?P?were?inferior?to?those?parameters?in?group?E(P<0.05).?Conclusion?Effects?of?equivalent-dose?propofol?anesthesia?induction?by?target-controlled?infusion?has?more?stable?hemodynamic?than?TCI?etomidate.?Application?etomidate?for?anesthesia?induction?has?litter?effects?on?the?cardiovascular?and?was?more?suitable?for?surgery?under?general?anesthesia.