七氟醚潮气量法麻醉诱导对成年女性患者左心功能的影响  

Effects of sevoflurane inhalation induction using tidal volume method on left heart function in adults 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,沈阳市110004 [2]中国医科大学附属盛京医院超声科,沈阳市110004

出　　处：《临床麻醉学杂志》2015年第3期224-227,共4页Journal of Clinical Anesthesiology

摘　　要：目的探讨七氟醚潮气量麻醉诱导方法对成年女性患者左心功能的影响。方法选择拟全麻下妇科手术患者20例,年龄20-48岁,ASAⅠ或Ⅱ级。患者平静自主呼吸,吸入6%七氟醚,氧流量6L/min,监测呼气末七氟醚浓度达2.0MAC值后,维持2.5min,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30s（T2）和置入喉罩3min（T3）的心脏每搏量（SV）、左室舒张末容积（LVEDV）、射血分数（EF）、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指数及MAP,并记录意识消失和诱导完成时间及不良反应的发生情况。结果与T0时比较,T1-T3时SV、EF、TDI E/A、Tei指数明显增加（P〈0.05）;HR、Sa、Ea、Aa明显减慢（P〈0.05）;LVEDV、CO和MAP变化差异无统计学意义。20例患者诱导及喉罩置入顺利,无喉痉挛等不良反应发生。结论七氟醚潮气量法诱导对成年女性左心功能有一定的抑制作用,但这种抑制作用对循环影响不明显。Objective To observe the effects of sevoflurane inhalation induction using tidal volume method on left heart function in normal adult females.Methods Twenty adult female patients,aged 25-48 years,ASA Ⅰ orⅡ,scheduled for gynecologic operation were enrolled.Patients were inducted with sevoflurane 6% at the flow of 6L/min.Laryngeal masks were placed 2.5min 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）,HR,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 MAP of all the patients were measured and recorded at the time of before（T0）and after induction（T1）and after insertion of laryngeal mask（T2）and3min after insertion of laryngeal mask（T3）.In addition,the time of losing consciousness,the duration of induction and incidence of adverse reactions were also recorded.Results Compared with the baseline values at T0,the levels of SV,EF,TDI E/A,Tei index increased significantly（P〈0.05）,and HR,Sa,Ea,Aa decreased significantly at T1-T3（P〈0.05）,while the change of LVEDV,CO and MAP showed no statistical significance.The insertion process was eventless in all the 20 patients and no adverse event such as laryngospasm was recorded.Conclusion The left cardiac function of adult females could be inhibited by sevoflurane induction with the tidal volume method,while the hemodynamics were not significantly influenced.

关 键 词：七氟醚 吸入诱导 心功能 组织多普勒 

分 类 号：R614[医药卫生—麻醉学]