天津医药
天津醫藥
천진의약
Tianjin Medical Journal
2015年
10期
1175-1178
,共4页
冀佳佳%朱迎梅%代志刚%郭安梅
冀佳佳%硃迎梅%代誌剛%郭安梅
기가가%주영매%대지강%곽안매
麻醉,全身%芬太尼%插管法,气管内%光电容积脉搏波%伤害性应激反应%灌注指数%肾上腺素%去甲肾上腺素
痳醉,全身%芬太尼%插管法,氣管內%光電容積脈搏波%傷害性應激反應%灌註指數%腎上腺素%去甲腎上腺素
마취,전신%분태니%삽관법,기관내%광전용적맥박파%상해성응격반응%관주지수%신상선소%거갑신상선소
anesthesia,general%fentanyl%intubation,intratracheal%photoplethysmography%nociceptive stress%perfu-sion index%epinephrine%norepinephrine
目的：评价指端光电容积脉搏（PPGPW）波的变化用于监测全麻诱导期机体伤害性应激反应的准确性。方法根据麻醉诱导期75例患者对芬太尼的剂量按4、5及6μg/kg分为F4、F5、F6组，每组25例。分别于入室时（T1）、诱导后2 min（T2）、气管插管即刻（气管插入声门10 s，T3）、插管后1 min（T4）及插管后5 min（T5）连续监测并记录患者心率（HR）、收缩压（SBP）、舒张压（DBP）、血氧饱和度（SpO2）、手指温度、末梢灌注指数（PI）、血浆肾上腺素（E）、去甲肾上腺素（NE）及PPGPW波并测量其振幅（PPGA）。结果与T1相比，T2和T53组PPGA及PI升高，E和NE减小（P<0.05），T3时刻F4组和F5组PPGA及PI降低，NE升高（P<0.01），F4组E升高（P<0.05），F5组E无明显变化（P>0.05）；F6组T2、T3、T4和T5时刻PPGA和PI均升高，E和NE均减小（P<0.05）。PPGA与E、NE呈负相关（r分别为-0.406和-0.484，P<0.05），PI与E、NE呈负相关（r分别为-0.378和-0.440，P<0.05）。结论 PPGA和PI与伤害性应激反应程度呈负相关，可以准确监测全麻诱导期的伤害性应激。
目的：評價指耑光電容積脈搏（PPGPW）波的變化用于鑑測全痳誘導期機體傷害性應激反應的準確性。方法根據痳醉誘導期75例患者對芬太尼的劑量按4、5及6μg/kg分為F4、F5、F6組，每組25例。分彆于入室時（T1）、誘導後2 min（T2）、氣管插管即刻（氣管插入聲門10 s，T3）、插管後1 min（T4）及插管後5 min（T5）連續鑑測併記錄患者心率（HR）、收縮壓（SBP）、舒張壓（DBP）、血氧飽和度（SpO2）、手指溫度、末梢灌註指數（PI）、血漿腎上腺素（E）、去甲腎上腺素（NE）及PPGPW波併測量其振幅（PPGA）。結果與T1相比，T2和T53組PPGA及PI升高，E和NE減小（P<0.05），T3時刻F4組和F5組PPGA及PI降低，NE升高（P<0.01），F4組E升高（P<0.05），F5組E無明顯變化（P>0.05）；F6組T2、T3、T4和T5時刻PPGA和PI均升高，E和NE均減小（P<0.05）。PPGA與E、NE呈負相關（r分彆為-0.406和-0.484，P<0.05），PI與E、NE呈負相關（r分彆為-0.378和-0.440，P<0.05）。結論 PPGA和PI與傷害性應激反應程度呈負相關，可以準確鑑測全痳誘導期的傷害性應激。
목적：평개지단광전용적맥박（PPGPW）파적변화용우감측전마유도기궤체상해성응격반응적준학성。방법근거마취유도기75례환자대분태니적제량안4、5급6μg/kg분위F4、F5、F6조，매조25례。분별우입실시（T1）、유도후2 min（T2）、기관삽관즉각（기관삽입성문10 s，T3）、삽관후1 min（T4）급삽관후5 min（T5）련속감측병기록환자심솔（HR）、수축압（SBP）、서장압（DBP）、혈양포화도（SpO2）、수지온도、말소관주지수（PI）、혈장신상선소（E）、거갑신상선소（NE）급PPGPW파병측량기진폭（PPGA）。결과여T1상비，T2화T53조PPGA급PI승고，E화NE감소（P<0.05），T3시각F4조화F5조PPGA급PI강저，NE승고（P<0.01），F4조E승고（P<0.05），F5조E무명현변화（P>0.05）；F6조T2、T3、T4화T5시각PPGA화PI균승고，E화NE균감소（P<0.05）。PPGA여E、NE정부상관（r분별위-0.406화-0.484，P<0.05），PI여E、NE정부상관（r분별위-0.378화-0.440，P<0.05）。결론 PPGA화PI여상해성응격반응정도정부상관，가이준학감측전마유도기적상해성응격。
Objective To envaluate the accuracy of Photoplethysmograph pulse wave in monitoring stress reaction to harmful stimulation. Methods Patients (n=75) were randomly assigned to three groups according to the dosages of fentanyl that were administrated ( 4, 5 and 6 g/kg were given to F4, F5, F6 group respectively (n=25) in each group. Heart rate (HR), Systemic blood pressure (SBP), Diastolic blood pressure (DBP), SpO2, the skin temperature of finger, perfusion index (PI), epi?nephrine(E) and Norepinephrine (NE) were recorded at following time points:just in operation room (T1), 2 min after induc?tion (T2), at intubation (T3),1 min (T4) and 5 min (T5) after intubation. And the PPGPW was printed and measured at the same time points. Results PPGA and PI were significantly increased while E and NE were significantly decreased in T2 and T5, compared with those baseline at T1 (P < 0.05). At T3, PPGA and PI were significantly decreased while NE markedly in?creased in group F4 and F5 compared to T1. At T3, E in group F4 were remarkably increased h while E in group F5 were of no obvious changed, compared with those at T1(P<0.05). PPGA and PI increased while E and NE decreased in group F6 at T2, T3 ,T4 and T5 compared with those at T1 (P<0.05). In summary, PI was negatively correlated with plasma E and NE while PP?GA was negatively correlated with plasma E and NE .Conclusion PPGA and PI are negatively associated with intensity of stress response. And they can reflect the stress reaction during the induction period of intravenous anesthesia accurately.
