不同剂量羟乙基淀粉电解质注射液预输注对胃切除术患者全麻诱导期血流动力学的影响  

Effect on hemodynamics of pre-infusion of different doses hydroxyethyl starch electrolyte injection in gastrectomy patients during induction of anesthesia

作　　者：狄美霞 焦玉娟[2] 王玲玲[1] 王文娟[1] 赵亚娟[1] 王伟芝[2] 

机构地区：[1]潍坊医学院麻醉学系,山东省潍坊市261053 [2]潍坊市人民医院麻醉科

出　　处：《临床麻醉学杂志》2015年第6期559-561,共3页Journal of Clinical Anesthesiology

摘　　要：目的探讨不同剂量6%羟乙基淀粉130/0.4电解质注射液预输注对胃切除术患者全麻诱导期血流动力学的影响。方法择期行胃切除术患者90例,ASAⅠ或Ⅱ级,年龄40～50岁,根据全麻诱导前30min输注6%羟乙基淀粉130/0.4电解质注射液的剂量随机分为低剂量组（L组,5ml/kg）、中剂量组（M组,10ml/kg）和高剂量组（H组,15ml/kg）。以丙泊酚2mg/kg、罗库溴铵0.9mg/kg、舒芬太尼0.5μg/kg麻醉诱导。以FloTrac/Vigileo方法测定并记录输注前（T1）、诱导前（T2）、气管插管前（T3）时的HR、MAP、心指数（CI）、每搏量（SV）、每搏变异度（SVV）、外周血管阻力（SVR）、CVP。结果与T1时比较,T2、T3时三组患者MAP、CI、SV、CVP均明显升高,HR明显减慢,SVV、SVR明显降低（P〈0.05）。与L组比较,T2、T3时M组和H组HR明显减慢,MAP、SV、CVP明显升高,SVV和SVR明显降低,且H组MAP和CVP明显高于M组,SVR明显低于M组（P〈0.05）。结论全醉诱导前输注6%羟乙基淀粉130/0.4电解质注射液10ml/kg可有效预防胃切除术患者全麻诱导期低血压的发生,维持相对稳定的血流动力学。Objective To investigate the effects of pre-infusion different doses 6% hydroxyethyl starch 130/0.4electrolyte injection before the induction of anesthesia on hemodynamics during general anesthesia induction in gastrectomy patients.Methods Ninety patients of both sexes,ASA ⅠorⅡ adults aged 40-50 years,scheduled for elective gastrectomy,were randomly divided into 3groups according to the dosage of 6% hydroxyethyl starch 130/0.4electrolyte injection infused before general anesthesia induction（n=30each）：the low dose group（group L,5 ml/kg）,the middle dose group（group M,10 ml/kg）,the high dose group（group H,15 ml/kg）.Anesthesia was induced with propofol 2mg/kg,rocuronium 0.9mg/kg and sufentanil 0.5μg/kg.HR,MAP,CI,SV,SVV,SVR,CVP were measured at the time before infusion（T1）,before induction（T2）,after induction（T3）by FloTrac/Vigileo.Results Compared with T1,MAP,CI,SV and CVP were increased significantly at T2 and T3,while HR,SVV and SVR were decreased in all groups（P〈0.05）.Compared with group L,HR,SVV and SVR in groups M and H were decreased at T2 and T3,while MAP,SV and CVP were increased（P〈0.05）.Compared with group M,MAP and CVP in group H were higher and SVR were lower at T2 and T3（P〈0.05）.Conclusion Infusion of 6% hydroxyethyl starch 130/0.4electrolyte injection 10ml/kg before induction of anesthesia can effectively decrease occurrence of low blood pressure in patients underwent elective gastrectomy during general anesthesia induction,and maintain a relatively stable hemodynamics.

关 键 词：羟乙基淀粉 胃切除术 全麻 血流动力学 

分 类 号：R614.2[医药卫生—麻醉学]