不同剂量人工胶体液在麻醉诱导期预填充对血流动力学的影响  

Effects of different doses of colloid on systemic hemodynamics during general anesthesia induction

作　　者：董泉[1] 张富军[1] 于布为[1] 

机构地区：[1]上海交通大学医学院瑞金医院麻醉科,上海200025

出　　处：《上海交通大学学报（医学版）》2009年第6期725-728,共4页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的探讨在麻醉诱导阶段给予不同剂量的人工胶体补偿性容量预填充与代偿血管舒张引起的血压下降之间的关系。方法50例择期行胃肠道手术的患者,全身麻醉前30 min内输入平衡液和4%琥珀酰明胶液,按胶体液量之多少随机分为0 (对照组,仅输入晶体液)、4、8、12及15 mL/kg组,行补偿性容量预填充。在输液第25 min时(即输液结束前5 min)行麻醉诱导,比较组间麻醉诱导前后的血液动力学指标变化。结果诱导前后舒张压和平均动脉压的变化值与胶体填充量相关(r=-0.657,P<0.01)。8、12、15 mL/kg组与对照组相比差异均有统计学意义(P<0.05),而此三组组间比较无显著差异。结论全麻诱导前给予一定量的人工胶体预填充,对预防麻醉诱导引起的低血压有一定的作用。特别是当补偿性扩容量达到8 mL/kg以上时,有利于维持诱导期循环的稳定。Objective To explore the relationship between administration of different doses of colloid before general anesthesia induction and general anesthesia-induced hypotension. Methods Fifty patients for selective gastrointestinal operations were randomly divided into 5 groups according to the volume of colloid administered 30 min before general anesthesia induction： 0 mL/kg group （control group）, 4 mL/kg group, 8 mL/kg group, 12 mL/kg group and 15 mL/kg group. To replace the deficit of hypovolemia before operation, crystalloid was given to each patient. Anesthesia was induced with propofol 25 min after infusion. Hemodynamic parameters were compared before and after anesthesia induction among groups. Results The changes in diastolic blood pressure and mean arterial blood pressure were related to colloid supplementation volume （r = -0. 657, P 〈 0.01）. There were significant differences between control group and 8 mL/kg group, 12 mL/kg group and 15 mL/kg group （P 〈 0.05）, while there was no significant difference among 8 mL/kg group, 12 mL/kg group and 15 mL/kg group. Conclusion Administration of colloid before general anesthesia induction attenuates the severity of general anesthesia-induced hypotension, especially when the dose of colloid is over 8 mL/kg.

关 键 词：容量治疗 补偿性容量扩充 诱导期 血流动力学 低血压 

分 类 号：R614.1[医药卫生—麻醉学]