异丙酚在心脏瓣膜置换术中对氧供、氧耗、氧摄取率及氧合状态的影响  

Effect of Propofol on Oxygen Dilivery, Consumption,Extraction Rate and Oxygenation State in Patients Undergoing Valve Replacement

作　　者：周建美[1] 刘流[1] 陈启智[1] 吕志平[1] 

机构地区：[1]湖南医科大学附属二院麻醉学教研室,长沙市410011

出　　处：《临床麻醉学杂志》2000年第2期67-69,共3页Journal of Clinical Anesthesiology

摘　　要：目的 :观察异丙酚在心脏瓣膜置换术中对氧供 (DO2 )、氧耗 ( VO2 )、氧摄取率 (ERO2 )及氧合状态的影响。方法 :2 0例心脏瓣膜置换术病人随机分为两组。观察组麻醉诱导与维持用异丙酚 ,对照组用咪唑安定。观察体外循环 (CPB)期间DO2 、 VO2 、ERO2 、混合静脉血氧饱和度 (S VO2 )及动脉血乳酸 (ABL)的变化。结果 :(1)组内各时点DO2无明显变化 ,复温后观察组ERO2 增加非常显著 (P <0 0 1) ;降温开始及复温后观察组 VO2 、ERO2 显著低于对照组 (P<0 0 5 )。 (2 )组内S VO2 复温后下降 ,ABL增加 ,与最低温时比较差异非常显著 (P <0 0 1) ;观察组S VO2 在降温开始及复温后显著高于对照组 (P <0 0 5 ) ,ABL复温后显著低于对照组 (P <0 0 5 )。结论 :CPB期间低流量灌注和血液稀释 ,DO2 相对不足的状态下 ,异丙酚减少组织 VO2 、ERO2 。Objective: The effects of propofol on oxygen dilivery (DO 2),consumption(O 2),extraction rate(ERO 2)and oxygenation state in patients undergoing valve replacement were studied.Methods:20 patients were randomly divided into two groups.Anesthesia was induced and maintained with propofol in patients of observed group,while midazolan was used in the control group.Changes of DO 2,O 2,ERO 2,S O 2 and arterial blood lactate(ABL) were observed during cardiopulmonary bypass(CPB).Results:There was a significant increase in O 2 and ERO 2 during rewarming(P<0 01) and no significantly difference in DO 2 occured between two groups.In observed group,O 2 and ERO 2 decreased and S O 2 increased significantly at the beginning of hypothermia and during rewarming,ABL after rewarming was significantly lower in test group than that in control group. Conclusion:Propofol decreases O 2 and ERO 2 during low flow CPB.There is a certain protective effect on oxygen supply demand balance during CPB.

关 键 词：异丙酚 氧供 氧耗 心脏瓣膜置换术 ERO2 

分 类 号：R971.2[医药卫生—药品]