七氟烷与丙泊酚对心脏双瓣置换术患者血流动力学影响的比较  

Effects of sevoflurane and propofol on hemodynamic changes in patients undergoing cardiac double valve replacement

作　　者：李洋 

机构地区：[1]浙江绿城心血管病医院麻醉科,浙江省杭州310012

出　　处：《中国基层医药》2016年第1期106-109,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨心脏双瓣置换术患者在麻醉期间使用七氟烷、丙泊酚对其血流动力学的影响。方法将收治的80例风湿性心脏病患者根据麻醉药物的选择不同分为七氟烷组和丙泊酚组，对比两种麻醉药物对患者血流动力学、心功能的影响。结果经方差分析显示，两组患者同时间点血氘代试剂（CIL）浓度、每搏输出量指数（SVI）以及左心室做功指数（LVSWI）差异有统计学意义（F=2．467、2．4783、2．553，P=0．032、0．032、0．021），两组患者不同时点间、组间不同时点间的MAP、HR、PAWP、CIL、SVI以及LVSWI的差异有统计学意义（不同时间点：F=2．597、2．468、2．523、2．589、2．532、2．556，P=0．032、0．021、0．030、0．021、0．024、0．023；组间不同时间点：F=2．597、2．468、2．523、2．497、2．479、2．538，P=0．032、0．021、0．030、0．034、0．034、0．038）。两组患者在手术期间未见肝肾功能有明显损害。结论七氟烷与丙泊酚对风湿性心脏病施行心脏双瓣置换术的患者在麻醉期间对血流动力学和心功能的影响基本相同，对肝肾功能无明显影响，安全性高。Objective To investigate effects of sevoflurane and propofol on hemodynamic changes in patients undergoing cardiac double valve replacement. Methods Totally 80 patients admitted with rheumatic heart disease were divided into sevoflurane group and propofo] groups. The anesthetic drugs on hemodynamics, myocardial function and renal function were compared. Results There were statistically significant in CIL concentration, stroke volume index （SVI） and left ventricular -stroke work index （LVSWI） levels between the two groups at the same time points （F = 2. 467,2. 4783,2. 553, P = 0. 032,0. 032,0. 021 ）. The levels of MAP, HR, PAWP, CIL, SVI and LVSWITBIL between the two groups were statistically significant at different time points （F = 2. 597,2. 468,2. 523,2. 589,2.532, 2. 556,P = 0. 032,0. 021,0. 030,0. 021,0. 024,0. 023 ）, and difference at the same group at different time points （ F = 2. 597,2. 468,2. 523,2. 497,2. 479,2. 538, P = 0. 032,0. 021,0. 030,0. 034,0. 034,0. 038 ）. No obvious liver and renal function damage was found during the surgery in the two groups. Conclusion Anesthesia induction of sevoflurane and propofol for patients undergoing cardiac double valve replacement has similar effects on the hemodynamics and cardiac function, without obvious damage to liver and renal function.

关 键 词：心脏瓣膜置换术 七氟烷 丙泊酚 缺血/再灌注 血流动力学 

分 类 号：R614[医药卫生—麻醉学]