吸入麻醉药对低出生体质量新生儿血液动力学的影响  

The Haemodynamic Effects of Inhalation Anesthetics in Neonates with Low Birth Weight

作　　者：邓萌[1] 汤顺荣[1] 郑珊[1] 

机构地区：[1]复旦大学附属儿科医院麻醉科,上海201102

出　　处：《中国临床医学》2008年第6期883-885,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:分析安氟烷、异氟烷、七氟烷对低出生体质量新生儿的血液动力学的影响。方法:收集新生儿外科2000年1月—2007年5月收治的低出生体质量新生儿131例。分析所有病例的疾病构成、一般情况、麻醉方法以及手术期间心率(HR)、无创血压(BP)、脉搏血氧饱和度(SpO2)和呼气末二氧化碳分压(PETCO2)情况。结果:共105例入选本次回顾研究,根据吸入麻醉药不同分为3组:安氟烷组(Enf)、异氟烷组(Iso)和七氟烷组(Sev)。3组患儿日龄、体质量、手术时间、性别和ASA评分构成比差异均无统计学意义。Enf组心率(148±15)次.min-1明显快于Iso组心率(138±12)次.min-1和Sev组心率(137±14)次.min-1(P<0.01)。3组BP、SpO2、PETCO2值差异均无统计学意义。结论:低出生体质量新生儿吸入安氟烷或异氟烷或七氟烷维持麻醉时,控制呼气末麻醉气体浓度在1.0～1.5MAC(最低肺泡气有效浓度,参考成人吸入麻醉药的MAC值计算)较合适。Objective：To analyze haemodynamic alterations induced by enflurane, isoflurane and sevoflurane during the mainte nance of anesthesia for neonates with low birth weight. Methods： The clinical data of one-hundred and thirty-one ASA Ⅱ , Ⅲ or Ⅳ low-birth-weight neonates during operation performed under general anesthesia were reviewed and analyzed. All were hospitalized our hospital from January 2000 to May 2007. Results： One-hundred and five neonates were enrolled this retrospective studies. They were allocated into one of three groups by different inhalation anesthetics： group Enf （n = 45）, group Iso （n = 39） and group Sev （n = 21）. Demographic data were not different among the three groups. The total end tidal MAC （minimum alveolar concentration） values of all neonates were maintained from 1.0 to 1.5. No significant differences in mean arterial blood （MAP）, systolic arterial pressure （SAP）, diastolic arterial pressure （DAP）, pulse oxygen saturation （SpO2） and end tidal carbon dioxide （PETCOe） among three groups were observed. HR in group Enf, group Iso, and group Sev were respectively （148± 15） bpm, （138± 12） bpmand （137± 14） bpm. HR in group Enf is significantly higher than in group Iso （P〈0.01） and in group Sev （P〈0.01）. Conclusion：The anesthesia for neonates with low birth weight maintained with enflurane, isoflu rane or sevoflurane at 1.0-1.5 MAC end-tidal concentration is suitable.

关 键 词：婴儿 出生时低体质量 婴儿 新生 吸入麻醉药 血液动力学现象 

分 类 号：R614.2[医药卫生—麻醉学]