CAJ | 학술논문

目的:观察七氟烷吸入诱导与咪唑安定-芬太尼-丙泊酚诱导用于成人失血性休克的血流动力学效果以及不良反应的发生情况. 方法:选择拟行手术的失血性休克患者80例,随机分为观察组和对照组,对照组采用静脉注射咪唑安定-芬太尼-丙泊酚诱导麻醉,观察组吸入7 %七氟烷诱导麻醉,监测并记录两组患者入手术室后诱导前平均动脉压( mean arterial pres-sure,MAP)、心率( heart rate,HR)、诱导期去甲肾上腺素用量、从开始诱导至插管时间,插管前心率、插管后心率等. 统计两组患者诱导期发生不良反应例数. 结果:两组患者的入室后MAP、HR无明显差异( P >0. 05),两组患者诱导至插管时间比较,观察组短于对照组( P <0. 05),两组患者诱导后MAP皆有降低趋势,但对照组维持血压平稳所需血管活性药物去甲肾上腺素用量多于观察组( P <0. 05),两组患者诱导后HR皆有下降趋势,其中插管前心率对照组慢于观察组( P <0. 05),插管后心率对照组与观察组相比无差异( P >0. 05). 结论:七氟烷吸入全麻诱导用于失血性休克患者比咪唑安定-芬太尼-丙泊酚静脉诱导更为安全快速.
목적:관찰칠불완흡입유도여미서안정-분태니-병박분유도용우성인실혈성휴극적혈류동역학효과이급불량반응적발생정황. 방법:선택의행수술적실혈성휴극환자80례,수궤분위관찰조화대조조,대조조채용정맥주사미서안정-분태니-병박분유도마취,관찰조흡입7 %칠불완유도마취,감측병기록량조환자입수술실후유도전평균동맥압( mean arterial pres-sure,MAP)、심솔( heart rate,HR)、유도기거갑신상선소용량、종개시유도지삽관시간,삽관전심솔、삽관후심솔등. 통계량조환자유도기발생불량반응례수. 결과:량조환자적입실후MAP、HR무명현차이( P >0. 05),량조환자유도지삽관시간비교,관찰조단우대조조( P <0. 05),량조환자유도후MAP개유강저추세,단대조조유지혈압평은소수혈관활성약물거갑신상선소용량다우관찰조( P <0. 05),량조환자유도후HR개유하강추세,기중삽관전심솔대조조만우관찰조( P <0. 05),삽관후심솔대조조여관찰조상비무차이( P >0. 05). 결론:칠불완흡입전마유도용우실혈성휴극환자비미서안정-분태니-병박분정맥유도경위안전쾌속.
Objective:To observe hemodynamic effects and the occurrence of adverse reactions between sevoflurane inhalation induction and midazolam, fentanyl and propofol intravenous coinduction anesthesia for adult patients with hemorrhagic shock. Methods:80 patients with hemorrhagic shock selected for surgery were randomly divided into the observation group and the control group, the former given inhaled 7%sevoflurane, and the latter given midazolam, fentanyl and propofol intravenous coinduction. Measurements of the mean arterial pressure ( MAP) and heart rate ( HR) were performed in the two groups. During anesthesia induction, the HR of patients before induction and before and after endotracheal intubation were documented, meanwhile, the numbers of adverse reactions cases, doses of norepinephrine, and the duration from the beginning of anesthesia induction to the endotracheal intubation were recorded. And alterations were evaluated by statistical methods. Results:There were no significant differences in HR and MAP before induction between the two groups ( P >0. 05). The duration from the beginning of anesthesia induction to the endotracheal intubation in the observation group was significantly shorter in comparison with that in the control group( P <0. 05). After induction, the MAP of the two groups was inclined to decrease, and the dose of norepinephrine required to maintain blood pressure stable in the control group was more than that of the observation group( P <0. 05). The HR of the two groups had the tendency to incline after induction, and the HR before endotracheal intubation in the control group was slower than that in the observation group, with difference significant( P <0. 05). There was no significant difference in the HR after endotracheal intubation be-tween the two groups( P >0. 05). Conclusion:For patients with hemorrhagic shock, sevoflurane inhalation induction is much safer and fas-ter than midazolam,fentanyl and propofol intravenous coinduction anesthesia.