依托咪酯与七氟醚对二尖瓣置换术患者麻醉诱导期血流动力学及应激反应的影响  

Comparation of hemodynanics and stress response between etomidate and sevoflujrane in patients undergoing mitral valve replacement surgery during induction of general anesthesia

作　　者：秦怀峰[1] 马亚[1] 蒲新[1] 刘玉[1] 

机构地区：[1]安徽省皖北煤电集团总医院麻醉科,安徽宿州234011

出　　处：《河北联合大学学报（医学版）》2012年第3期299-301,共3页Journal of North China Coal Medical College

摘　　要：①目的比较依托咪酯与七氟醚对二尖瓣置换术患者麻醉诱导期血流动力学及应激反应的影响。②方法二尖瓣置换术患者40例,随机均分为2组,为依咪酯组(E组)、七氟醚组(S组)。E组采用依托咪酯静脉诱导;S组采用七氟醚吸入诱导。观测2组患者在入室后(T1)、插管即刻(T2)、气管插管后3min(T3)、气管插管后10min(T4)时的MAP、HR、SPO2、血清皮质醇(Cor)、血糖(Glu)、血乳酸(Lac)浓度。③结果 T3、T4时2组MAP比T1时显著降低(P<0.01),2组间比较,S组MAP比E组显著降低(P<0.01);T3时2组皮质醇均比T1时显著降低,E组(P<0.01)、S组(P<0.05),T4时2组皮质醇变化不明显;T3、T4时2组血糖与T1比较显著降低(P<0.05)。2组患者各时点的乳酸浓度、HR、SPO2变化无显著差异(P>0.05)。④结论依托咪酯用于二尖瓣置换术麻醉诱导,对维持循环的稳定、减轻诱导期应激反应方面优于七氟醚。Objective To compare the effects of etomidate and sevoflurane on hemodynamics and stress response in patients and ergoing mitral valve replce - ment surgery during induction of general anesthesia. Methods 40 patients scheduled for mitral valve replacement surgery were randomly derided into 2 groups （E/S） , In group E, anesthsia was induced with 0.1 ~ 0.3mg/kg etomidate and maintained with 2 - 61μg/kg/min etomidate during induction of general anesthesia; In group S, anesthesin was induced with sevoflurane and 1% -2% sevoflurane inhaled for maintainence during induction of general anesthesia. Hemodynamies parameters were recorded before anesthesia （ T1 ） , time just after induction （ T2 ） ,2min（ T3 ） and 10rnin（ T4 ） after induction. Cortisol（Cot） , glu- cose （Glu） and lactic acid （Lac） were measured at T1 - T4. Results Compared with T1 , MAP significantly decreased in both groups at T2 - T4 （ P 〈 0.01 ）. MAP in group S was significantly lower than in group E（ P 〈 0.01 ） ; Compared with T1, Cot at T3 decreased significantly（ P 〈 0.05 or P 〈 0.01 ） in both groups compaerd with T1 , Cor at Ta do not change significantly;Compared with TI ,Glu were decreased significantly in both groups （ P 〈 0.05 ） ;Compared with T1 HR,SPO2 and Lac do not decreased or increased significantly（ P 〉 0.05 ） in both groups. Conclusion Balanced anesthesia with etomidate excels sevoflarane in maintaining hemodynamics and alleviating stress respons in patients undergoing mitral valve replaement surgery during induction of general anesthesia.

关 键 词：二尖瓣置换术应激反应依托咪酯七氟醚血流动力学 

分 类 号：R654.2[医药卫生—外科学]