中国继续医学教育
中國繼續醫學教育
중국계속의학교육
China Continuing Medical Education
2015年
30期
60-62
,共3页
陈清霞%谢文吉%李顺元%颜景佳%谢文钦%叶燕乐
陳清霞%謝文吉%李順元%顏景佳%謝文欽%葉燕樂
진청하%사문길%리순원%안경가%사문흠%협연악
依托咪酯%老年患者%血流动力学%无创心排量
依託咪酯%老年患者%血流動力學%無創心排量
의탁미지%노년환자%혈류동역학%무창심배량
Etomidate%Midazolam%Fentanyl%Myoclonu
目的:观察依托咪酯与咪达唑仑用于老年患者在麻醉诱导期对于无创心排量的影响。方法收集60个病例,ASA分级I~Ⅱ级全身麻醉手术患者,开放外周静脉,随机分为依托咪酯(A)、咪达唑仑(B)两组,A组用依托咪酯诱导,剂量为0.15 mg/kg,复合靶控输注瑞芬太尼;B组用咪达唑仑诱导,剂量为0.1 mg/kg同样复合靶控输注瑞芬太尼,观察记录诱导前(T0),诱导后(T1)与插管即刻(T2)、插管后1 min(T3)、插管后3 min(T4)的平均动脉压(MAP)、心率(HR)、心排血量(CO)、心排指数(CI)及外周阻力(SVR)。结果依托咪酯组T1、T2、T3、T4时的MAP、HR、CO、CI、SVR与诱导前相比,差异无统计学意义;咪达唑仑组T1、T2、T3、T4时的MAP、HR、CO、CI、SVR与诱导前相比差异有统计学意义。结论依托咪酯全身麻醉诱导后对老年患者血流动力学的影响与咪达唑仑相比较为平稳。
目的:觀察依託咪酯與咪達唑崙用于老年患者在痳醉誘導期對于無創心排量的影響。方法收集60箇病例,ASA分級I~Ⅱ級全身痳醉手術患者,開放外週靜脈,隨機分為依託咪酯(A)、咪達唑崙(B)兩組,A組用依託咪酯誘導,劑量為0.15 mg/kg,複閤靶控輸註瑞芬太尼;B組用咪達唑崙誘導,劑量為0.1 mg/kg同樣複閤靶控輸註瑞芬太尼,觀察記錄誘導前(T0),誘導後(T1)與插管即刻(T2)、插管後1 min(T3)、插管後3 min(T4)的平均動脈壓(MAP)、心率(HR)、心排血量(CO)、心排指數(CI)及外週阻力(SVR)。結果依託咪酯組T1、T2、T3、T4時的MAP、HR、CO、CI、SVR與誘導前相比,差異無統計學意義;咪達唑崙組T1、T2、T3、T4時的MAP、HR、CO、CI、SVR與誘導前相比差異有統計學意義。結論依託咪酯全身痳醉誘導後對老年患者血流動力學的影響與咪達唑崙相比較為平穩。
목적:관찰의탁미지여미체서륜용우노년환자재마취유도기대우무창심배량적영향。방법수집60개병례,ASA분급I~Ⅱ급전신마취수술환자,개방외주정맥,수궤분위의탁미지(A)、미체서륜(B)량조,A조용의탁미지유도,제량위0.15 mg/kg,복합파공수주서분태니;B조용미체서륜유도,제량위0.1 mg/kg동양복합파공수주서분태니,관찰기록유도전(T0),유도후(T1)여삽관즉각(T2)、삽관후1 min(T3)、삽관후3 min(T4)적평균동맥압(MAP)、심솔(HR)、심배혈량(CO)、심배지수(CI)급외주조력(SVR)。결과의탁미지조T1、T2、T3、T4시적MAP、HR、CO、CI、SVR여유도전상비,차이무통계학의의;미체서륜조T1、T2、T3、T4시적MAP、HR、CO、CI、SVR여유도전상비차이유통계학의의。결론의탁미지전신마취유도후대노년환자혈류동역학적영향여미체서륜상비교위평은。
Objective To observe the older patients’ cardiovascular responses to the inducement of Remifentanil combined respectively with midazolam andetomidate.Methods ASA grade I~II Total 60 patients with gener anesthesia and open outer vein were selected and randomly divided into groups of etomidate (group A)and midazolam(group B). Group A received TCI of Remifentanil and intravenou injection of etomidat, group B received TCI of remifentanil and intravenou injection of midazolam. A monitor was used to observe and record MAP, HR, CO,CI, and SVR separetedly at the time before anesthesia induction, the time after anesthesia induction, the time at intubation tube point, the time after intubation tube 1 and 3 min.Results There was no signiifcant changes of MAP, HR, CO,CI during T1, T2, T3, T4, and SVR in group A before and after the anesthesia induction, while in group B there was a significant decrease of MAP, HR, CO,CI during T1, T2, T3, T4, and SVR after the anesthesia inducement.Conclusion The inducement of etomidat gener anesthesia has smooth and steady effect on the elderly’s blood lfow dynamics than midazolam.