七氟醚吸入与丙泊酚静脉两种不同麻醉方式对心内直视手术患者心肺转流期间应激反应的影响  

The influence of anesthesia with sevoflurane inhalation and intravenous propofol on the stress response of patients undergoing open heart opera-tion during cardiopulmonary bypass

作　　者：林伟雄[1] 曾志文[1] 张岳农[1] 

机构地区：[1]广东省梅州市人民医院麻醉一科,广东梅州514031

出　　处：《中国当代医药》2014年第36期22-24,共3页China Modern Medicine

摘　　要：目的分析七氟醚吸入与丙泊酚静脉两种不同麻醉方式对心内直视手术患者心肺转流（CPB）期间应激反应的影响。方法抽取2011年9月-2013年9月本院行心内直视手术的70例患者为研究对象,采用抽签法将其随机分为观察组和对照组,对照组行丙泊酚静脉麻醉,观察组行七氟醚吸入麻醉。记录患者术前、CPB后30 min、CPB后6 h以及术后心率（HR）、平均动脉压（MAP）、皮质醇（Cor）以及血浆促肾上腺皮质激（ACTH）的变化情况。结果观察组患者CPB后30 min、CPB后6 h的MAP均较对照组低,差异有统计学意义（P〈0.05）。观察组CPB后30 min、CPB后6 h、术后的Cor、ACTH均较对照组低,差异有统计学意义（P〈0.05）。结论心内直视手术中CPB期间行七氟醚吸入麻醉,可降低患者手术应激反应,提高手术安全性。Objective To analyze the effect of anesthesia with sevoflurane inhalation and intravenous propofol on the stress response of patients undergoing open heart operation during cardiopulmonary bypass（CPB）. Methods 70 patients with open heart operation in our hospital from September 2011 to September 2013 were selected as research objects,and were randomly divided into control group and observation group,35 cases in each group,the control group were underwent intravenous anesthesia with propofol and the observation group were taken with sevoflurane inhalation anesthesia.The changes of heart rate（HR）,mean arterial pressure（MAP）,cortisol（Cor） and adrenocorticotropic hormone（ACTH）at preoperation,30 min after CPB,6 h after CPB and postoperation was recorded. Results MAP in the observation group at 30 min after CPB and 6 h after CPB was lower than that in the control group,the difference was significant（P〈0.05）.Cor and ACTH in the observation group at 30 min after CPB,6 h after CPB and postoperation was lower than that in the control group,the difference was significant（P〈0.05）. Conclusion Sevoflurane inhalation anesthesia during CPB in the open heart operation can reduce the stress reaction of patients,improve the operation safety.

关 键 词：心内直视手术 七氟醚吸入 丙泊酚静脉 心肺转流 应激反应 

分 类 号：R971.2[医药卫生—药品]