不同民族围术期血液稀释期间靶控输注异丙酚的可行性分析  

Feasibility analysis of target-controlled infusion by propofol during perioperative hemodilution in different nationalities

作　　者：刘琴[1] 付路易[2] 宣燕[3] 

机构地区：[1]新疆医科大学附属肿瘤医院妇外五科,乌鲁木齐830011 [2]新疆医科大学附属肿瘤医院急诊科,乌鲁木齐830011 [3]新疆医科大学第一附属医院麻醉科,乌鲁木齐830011

出　　处：《新疆医科大学学报》2012年第1期82-86,共5页Journal of Xinjiang Medical University

摘　　要：目的观察新疆地区不同民族病人急性等容血液稀释(ANHD)期间靶控输注(TCI)异丙酚血药浓度及血液动力学的变化,并探讨在新疆地区行ANHD的可行性。方法选择15例ASAⅠ～Ⅱ级全麻下择期行非心脏手术的病人,维吾尔族8例(Ⅰ组),汉族7例(Ⅱ组)。全麻后施行ANHD,血液稀释完成10min后,以恒定靶血浆药物浓度(3μg/mL)变速输注异丙酚60min,间断采血180min,应用气相色谱-质谱法测定异丙酚血药浓度。结果 (1)ANHD后两组病人红细胞压积(Hct)由(40.0±4.2)%和(39.7±3.9)%分别下降至(26.1±2.3)%和(25.0±1.6)%;血红蛋白(Hb)由(134.8±13.4)g/L和(135.7±13.8)g/L分别下降至(90.0±9.3)g/L和(82.9±7.6)g/L。Hct、Hb下降幅度两组间比较差异无统计学意义。(2)两组病人ANHD前后心率(HR)、收缩压(SBP)、舒张压(DBP)无显著变化。(3)TCI异丙酚期间两组病人实测血药浓度之间及每组病人各时点靶浓度与实测浓度的比较,差异均无统计学意义。结论在新疆地区维吾尔族成年病人以6%羟乙基淀粉溶液及林格氏液行AN-HD安全可行,且对ANHD期间TCI异丙酚血药浓度没有影响。Abstract： Objective To investigate the changes in propofol blood concentration and hemodynamics in dif ferent races when propofol was infused by target-controlled infusing pump during acute normovolemic he modilution （ANHD）, and the feasibil patients, aged between 20--60 years old of performing ANHD in Xinjiang. Methods Fifteen ASA I - Ⅱ , undergoing elective non-cardiac surgery under general anesthe sia, were allocated randomly into two groups： group I （Uyghur nationality, n =8） and group Ⅱ（Hannationality, n =7）. ANHD was performed after induction of general anesthesia. Ten minutes after ANHD, TCI of propofol with concentration of 3/~g/mL was started,it continued for 60 minutes. Intermittent blood collection was taken for 180 min, Blood concentration of propofol was tested by gas-chromatography-mass spectrometry （GC-MS）. Results （1） After ANHD, Hct of two group＇ patiehts decreased from （40.0±4.2）% and （39.7±3.9）% to （26.1±2.3）0/oo and （25.0±1.6）%, and Hb decreased from （134.8±13.4） g/Land （135.7±13.8）g/Lto （90.0±9.3）g/Land （82.9±7.6）g/I., respectively. Decrease amplitude of Hct and Hb were not significant difference between two groups. （2） The changes in HR, SBP, and DBP between the two groups were not statistic significance. （3） The changes in propofol blood concentrate dur- ing target-controlled infusion in the two groups were no statistic significance. Conclusion ANHD with 6% HES and Ringer＇s solution was safe in Uyghur people in Xinjiang. There was no effect of race （Uygur people and Han people） on propfol blood concentration during target-controlled infusion.

关 键 词：血液稀释 药物投予系统 二异丙酚 民族因素 

分 类 号：R473.6[医药卫生—护理学]