七氟醚肺活量法吸入诱导对成年女性左心功能的影响  

Effect of Sevoflurane vital capacity technique of inhalation induction on left heart function in adult females

作　　者：孙震[1] 孙晋慧 吕晶[1] 孙璐[2] 

机构地区：[1]中国医科大学附属盛京医院麻醉科,辽宁沈阳110004 [2]中国医科大学附属盛京医院超声科,辽宁沈阳110004

出　　处：《中国现代医学杂志》2014年第32期106-109,共4页China Journal of Modern Medicine

摘　　要：目的探讨七氟醚肺活量法吸入诱导对成年女性左心功能的影响。方法选择择期全身麻醉下妇科手术患者20例,年龄23-50岁,ASA分级Ⅰ或Ⅱ级,先以6%七氟醚,氧流量6 L/min预充麻醉机呼吸环路,患者按照测量肺活量的方式呼出肺内残余气后深呼吸,屏气5 s后再开始下一次呼吸。监测呼气末七氟醚浓度达2.0 MAC值后,并维持2.5 min,置入喉罩。使用多普勒技术采集麻醉诱导前（T0）、诱导后置入喉罩前（T1）、置入喉罩30 s（T2）和置入喉罩3 min（T3）4个时间点的心脏每搏量（SV）、左室舒张末容积（LVEDV）、射血分数（EF）、心率（HR）、心输出量（CO）、组织多普勒二尖瓣环后间隔侧E/A比值（TDI E/A）、二尖瓣环后间隔侧舒张早期心肌组织运动峰速度（Ea）、二尖瓣环后间隔侧舒张晚期心肌组织峰速度（Aa）、二尖瓣环后间隔侧收缩期心肌组织运动峰速度（Sa）、Tei指数（Tei）及平均动脉压（MAP）,并记录意识消失和诱导完成时间及有无不良反应发生。结果与T0时间点比较,T1、T2和T3时间点的SV、EF、TDI E/A、Tei指数增加（P〈0.05）,HR、Sa、Ea、Aa减小（P〈0.05）,LVEDV、CO变化差异无统计学意义;T1时间点的MAP降低（P〈0.05）,T2时间点的MAP增加（P〈0.05）,T3时间点的MAP差异无统计学意义。20例患者诱导后喉罩置入顺利,无喉痉挛及明显体动等不良事件发生。结论七氟醚肺活量法诱导对成年女性左心功能有一定的抑制作用。[Objective ] To observe the effects of Sevoflurane vital capacity method of inhalation induction on left heart function in normal adult females. [Methods] Twenty adult female patients, aged between 23 and 50 years old, ASA Ⅰ or Ⅱ grade, were scheduled for gynecologic operation. Prior to anesthesia, patients were instructed on the vital capacity technique for induction and the anesthetic circuit was first primed with 6% Sevoflurane. The anesthesia mask was applied and patients were asked to take a deep breath from the residual lung volume. Patients were encouraged to take vital capacity breaths until unconsciousness occurred. Laryngeal masks were placed 2.5 min after the end-tidal concentration of Sevoflurane reached 2.0 MAC. With the technique of Doppler, stroke volume （SV）, left ventricle end-diastolic volume （LVEDV）, ejection index （EF）, heart rate （HR）, blood pressure （BP）, cardiac output （CO）, E/A ratio by tissue Doppler of mitral valve ring after the interval side （TDI E/A）, peak early diastolic velocity of mitral annulus （Ea）, peak late diastolic velocity of mitral annulus （Aa）, peak systolic velocity of mitral annulus （Sa）, Tei index and mean arterial pressure （MAP） of all the patients were measured and recorded at the time of before and after induction and after insertion of laryngeal mask and after 3 min insertion of laryngeal mask, and the time of losing consciousness and lhat of inhalation took and the occurrence of adverse reactions were also recorded. [Results] Compared with the baseline values at To, the level of SV, EF, TIM E/A, Tel index increased significantly （P〈0.05） and HR, Sa, Ea, Aa decreased significantly （P〈0.05） at T1-3, the level of LVEDV, CO were not significantly change, MAP decreased significantly （P〈0.05） at T1 and increased significantly （P〈0.05） at T2 and were not significantly change at T3. The insertion process was eventless in all the 20 patients and no adverse event such as laryngospasm was recorded. [Concl

关 键 词：七氟醚 吸入诱导 心功能 组织多普勒 成年女性 

分 类 号：R614.2[医药卫生—麻醉学]