小剂量磷酸肌酸钠复合丙泊酚对老年心肌缺血患者血流动力学的影响  

Effects of small dose creatine phosphate sodium combined with propofol target controlled infusion on hemodynamics in senile patients with myocardial ischemia

作　　者：徐康清[1] 单智铭[1] 邵兴兴 修欢欢 黄贤君[1] 

机构地区：[1]中山大学附属第一医院麻醉科,广东广州510080

出　　处：《中国新药与临床杂志》2014年第7期507-510,共4页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的 观察小剂量磷酸肌酸钠复合丙泊酚靶控输注（TCI）对老年心肌缺血患者全麻手术诱导期血流动力学的影响。方法 选择拟行胃肠手术的心肌缺血患者200例,ASAⅡ～Ⅲ级,年龄70~95岁,随机分成对照组和试验组,每组100例。全麻诱导期试验组予磷酸肌酸钠0.5 g复合丙泊酚TCI,对照组则单独予丙泊酚TCI,两组丙泊酚靶浓度均设为0.004μg·L-1。两组其余麻醉方法均一致。于诱导前,诱导后1、3、5 min及诱导完毕时记录患者平均动脉压（MAP）、中心静脉压（CVP）,并观察两组低血压和室性心律失常的发生情况。结果 诱导前及诱导后1 min,两组MAP和CVP无显著差异（P〉0.05）。诱导后3、5 min及诱导完毕时,对照组MAP和CVP均低于试验组（P〈0.05）。试验组低血压与室性心律失常的发生率分别为19%和11%,均低于对照组（55%和42%）,差异有显著意义（P〈0.05）。结论小剂量磷酸肌酸钠复合丙泊酚TCI,可促进心肌缺血老年患者全麻诱导期血流动力学稳定,减少室性心律失常的发生。AIM To investigate the influences of small dose creatine phosphate sodium combined with propofol target controlled infusion （TCI） on hemodynamics during anesthesia induction in elder patients with myocardial ischemia. METHODS Two hundred patients, aged 70 - 95 years old, ASA scored Ⅱ～Ⅲ, scheduled for gastrointestinal surgeries with myocardial ischemia, were randomly allocated into control group （n = 100） and trial group （n = 100） . The patients in the trial group were given creatine phosphate sodium 0.5 g dissolved in sodium chloride injection 100 mL and propofol TCI, while sodium chloride injection 100 mL and propofol TCI were given to patients in the control group during anesthesia induction respectively. Other anesthetic methods were the same in two groups. Mean arterial pressure （MAP） and central venous pressure （CVP） were observed in all patients before anesthesia induction, 1 min, 3 min, 5 min after induction and at anesthesia induction finished. The occurrence of hypotension and ventricular arrhythmia were also observed. RESULTS The levels of MAP and CVP before and 1 min after induction showed no significant difference between two groups （P 〉 0.05） . However, compared with those in the control group, the levels of MAP and CVP 3 min, 5 min after induction and at anesthesia induction finished were significantly increased in the trial group （P 〈 0.05） . The incidence of hypotension and ventricular arrhythmia in the trial group were 19% and 11%, lower than those in the control group （55% and 42%, P 〈 0.05） . CONCLUTION Small dose creatine phosphate sodium combined with propofol TCI can make hemodynamic more stable during anesthesia induction in senile patients with myocardial ischemia, and with less incidence of ventricular arrhythmia.

关 键 词：磷酸肌酸 丙泊酚 心肌缺血 血流动力学 

分 类 号：R971[医药卫生—药品] R972[医药卫生—药学]