CAJ | 학술논문

目的：采用超声瞬时波强技术评估全麻诱导期患者心脏血流动力学变化情况，探讨其临床应用价值。方法选取我院全麻手术患者63例，随机分为丙泊酚组30例、依托咪酯组33例。应用超声瞬时波强技术（WI）分别对两组患者进行全麻诱导前、后的右侧颈总动脉相关参数的检测，包括瞬时加速度波强（W1），瞬时减速度波强（W2），负向波面积（NA）等数值，统计分析组别间参数的差异。结果①丙泊酚组全麻诱导前后的参数对比中，全麻诱导后血压、心率、W1、W2、NA 降低的差异有统计学意义（ P ＜0．05），而左室射血分数（LVEF）差异无明显统计学意义（ P ＞0．05）；依托咪酯组全麻诱导前后的参数对比中，血压、心率、W1、W2、NA 差异无明显统计学意义（ P ＞0．05）；②在两组全麻诱导后的比较中，丙泊酚组血压、W1低于依托咪酯组，差异有统计学意义（ P ＜0．05）；全麻诱导后丙泊酚组 LVEF 、心率、W2、NA 与依托咪酯组的差异无明显统计学意义（ P ＞0．05）。结论应用超声瞬时波强技术能对全麻诱导期患者心脏与血管系统的综合功能进行更加全面和准确的评价，为临床选择全麻麻醉药物及其监测的层面上提供无创、更有效的新方法。
목적：채용초성순시파강기술평고전마유도기환자심장혈류동역학변화정황，탐토기림상응용개치。방법선취아원전마수술환자63례，수궤분위병박분조30례、의탁미지조33례。응용초성순시파강기술（WI）분별대량조환자진행전마유도전、후적우측경총동맥상관삼수적검측，포괄순시가속도파강（W1），순시감속도파강（W2），부향파면적（NA）등수치，통계분석조별간삼수적차이。결과①병박분조전마유도전후적삼수대비중，전마유도후혈압、심솔、W1、W2、NA 강저적차이유통계학의의（ P ＜0．05），이좌실사혈분수（LVEF）차이무명현통계학의의（ P ＞0．05）；의탁미지조전마유도전후적삼수대비중，혈압、심솔、W1、W2、NA 차이무명현통계학의의（ P ＞0．05）；②재량조전마유도후적비교중，병박분조혈압、W1저우의탁미지조，차이유통계학의의（ P ＜0．05）；전마유도후병박분조 LVEF 、심솔、W2、NA 여의탁미지조적차이무명현통계학의의（ P ＞0．05）。결론응용초성순시파강기술능대전마유도기환자심장여혈관계통적종합공능진행경가전면화준학적평개，위림상선택전마마취약물급기감측적층면상제공무창、경유효적신방법。
Objective To estimate the change in cardiac hemodynamics of generally anesthetic patients with wave intensi‐ty ,and explore the clinical application value .Methods We selected 63 patients of generally anesthetic patients who were divided into propofol group (group 1 ,n = 30) and etomidate group (group 2 ,n = 33) at random ,then detected every group patients before and after induction of general anesthesia to wave intensity (W1) in the right common carotid artery so as to get the data of accelerating wave intensity (W1) ,decelerating wave intensity (W2) and negative area (NA) ,to compare the results of the above data .Results ① Comparing with the before ,the blood pressure ,heart rate ,W1 ,W2 ,NA were reduced after the in duction of general ansthesia by propofol ;and differences were statistically ( P < 0 .05) ;After induc‐tion of general anesthesia by propofol ,LVEF was not significantly statistical significance ( P > 0.05) .After induction of general anesthesia by etomidate ,the blood pressure ,heart rate ,LVEF ,W1 ,W2 and NA were not significantly statistical significance ( P > 0 .05) ; ② Comparing with the etomidate ,the blood pressure and W1 were reduced after the in duction of general ansthesia by propofol and differences were statistically ( P < 0 .05) ;and heart rate ,LVEF ,W2 ,NA were not significantly statistical significance ( P > 0 .05) .Conclusion The wave intensity technology can evaluate the comprehen‐sive function of the heart and vascular system in patients with general anesthesia more comprehensively and accurately .It’ s expected to be providenoninvasive and more effective choice of general anesthetic and new monitor method to clinic .