心脏瓣膜置换手术实施快通道麻醉的研究  

Study of fast track cardiac anesthesia for heart valve replacement operation

作　　者：顾颖红[1] 李敏仙[1] 刘苏[1] 马乃全[1] 周期[1] 符少川[1] 

机构地区：[1]海南医学院附属医院麻醉科,海南省海口570102

出　　处：《中国基层医药》2010年第18期2451-2453,共3页Chinese Journal of Primary Medicine and Pharmacy

基　　金：海南省卫生厅基金资助项目（琼卫2006-55号）

摘　　要：目的探讨小剂量芬太尼用于心脏瓣膜置换术快通道麻醉的可行性及安全性。方法随机将40例瓣膜置换术患者分为两组，每组20例，组Ⅰ为快通道麻醉，组Ⅱ为大剂量芬太尼麻醉。观察两组不同时闯段血压、心率、血氧饱和度、中心静脉压、体温、气道压变化，及术后拔管时间、监护室（ICU）停留时问、住院时间、肺部并发症，对各项观察值进行统计学分析。结果芬太尼用量（μg／kg）：组Ⅰ（23．25±1．32）比组Ⅱ（35．75±6．84）少（P〈0．05）；拔管时问、ICU停留时间、住院时间，组Ⅰ是（7．92±3．16）h、（25．12±7．50）h、（28．50±8．94）d，组Ⅱ是（13．70±5．63）h、（37．53±13．19）h、（38．00±12．90）d，组Ⅰ均较组Ⅱ短（P〈0．05）；组Ⅱ有4例肺部感染，组Ⅰ无肺部感染（P〈0．05）。结论小剂量芬太尼用于瓣膜置换术快通道麻醉安全可靠，可缩短术后拔管时间、ICU停留时间、住院时间，减少术后肺部并发症和住院费用。Objective To investigate the feasibility and safety with the low dose fentanyl for valve replacement fast track cardiac anesthesia. Methods 40 cases with cardiac valve replacement were divided into two groups, group Ⅰ ：20 cases with fast track anesthesia,group ：20 cases with large dose fentanyl anesthesia. The blood presure, HR, SpO2 , CVP, Temperature, airway pressure were observed at different time points. The postoperative extubation time, ICU stay, hospital stay,postoperative pulmonary complications were recorded. Results The fentanyl（μg/kg） of group Ⅰ （23.25 ± 1.32） was less than that of group Ⅱ （ 35.75 ± 6. 84） （ P 〈 0. 05 ） ; Extubation time （ hours ）, ICU stay （ hours）, length of stay （days） were （7.92 ±3.16）, （25.12 ± 7.50 ）, （28.50 ± 8.94） in group Ⅰ , and that were （ 13.70 ±5.63）, （37.53±13.19）, （38.00 ± 12. 90） in group Ⅱ. The group Ⅰ were shorter than the group Ⅱ ,P 〈 0. 05 ;There were four cases of lung infection in group Ⅱ , no one in group Ⅰ （ P 〈 0. 05 ） ; There were significant differences between the two groups. There were no significant differences in the remaining observations. Conclusion The low dose fentanyl anesthesia for fast track anesthesia in heart valve replacement surgery was reliable and safe;It could help to reduce postoperative extubation time, ICU stay time and hospital stay time and reduce postoperative pulmonary complications and hospital costs.

关 键 词：心脏瓣膜假体置入 心脏外科手术 麻醉 

分 类 号：R614[医药卫生—麻醉学]