急性超容量血液稀释对靶控输注二异丙酚准确性的影响  

The effect of acute hypervolemic hemodilution on the accuracy of target-controlled infusion propofol

作　　者：翟东[1] 王莉琴[1] 郭旋[2] 周正清[1] 李宜淮[1] 孙大金[3] 

机构地区：[1]解放军第八五医院麻醉科,上海200052 [2]上海市杨浦区中心医院麻醉科,上海200090 [3]上海交通大学医学院附属仁济医院麻醉科,上海200001

出　　处：《医学研究生学报》2006年第7期620-622,共3页Journal of Medical Postgraduates

基　　金：上海市杨浦区卫生系统学科带头人培养计划基金资助项目(批准号:2002AA002-009)

摘　　要：目的：评估急性超容量血液稀释（AHHD）对靶控输注（TCI）二异丙酚准确性的影响。方法：按美国麻醉标准协会（ASA）Ⅰ～Ⅱ级择期手术的患者16例，随机分为AHHD组和对照组，每组8例，TCI二异丙酚，分析血药浓度。计算样本的百分比预测误差（％PE）和组间个体内中位数预测误差（MDPE）、中位数绝对误差（MDAPE）。结果：两组患者在TCI初期均产生明显的超射。AHHD组和对照组的PE和绝对值PE分别为-5．46％、13．02％和-29．32％、40．84％。AHHD组和对照组中位数MDPE、MDAPE分别为-1．78％、19．40％和28．66％、42．37％。组间比较差异具有显著性意义（P〈0．01，P〈0．05）。结论：Marsh参数用于国人实测浓度和预测浓度的差异较大，但在AHHD的条件下，系统预测能力提高，实测浓度和预测浓度的差异变小。Objective ：To evaluate the effect of acute hypervolemic hemodilution on the accuracy of target-controlled infusion of propofol. Methods ： Sixteen ASA Ⅰ～Ⅱ patients were randomly divided into acute hypervolemic hemodilution group （AHHD group, n = 8 ） and control group （control group, n = 8）. Propofol was infused with target-controlled （Diprifusor-TCI） system. Arterial blood sample was taken for determination of plasma concentration measured by HPLC （Angilent 10000）. Predicted error （PE）, median predicted error （MDPE） and median absolute prediction error （MADPE） were calculated.Results： There was remarkable initial overshoot in both groups. PE and absolute PE were -5.46% and 13.02% in AHHD group and -29.32% and 40.84% in control group. The median value of MDPE and MDAPE were - 1.78% and 19.40% in AHHD group and 28.66% and 42.37% in control group. Conclusion ：TCI system with Marsh pharmacokinetic parameters had large difference in measured-predicted concentration. But the accuracy of the TCI system increased with AHHD.

关 键 词：二异丙酚 靶控输注 血液稀释 

分 类 号：R971.2[医药卫生—药品]