高脂血症因素对患者吸入七氟醚麻醉时肺摄取的影响  

Effect of hyperlipidemia on pulmonary uptake in patients inhaling sevoflurane for anesthesia

作　　者：刘艳秋[1] 任益民[1] 高鸿[1] 蒋柯[1] 曾丽[1] 张兴薇 

机构地区：[1]贵州医科大学附属医院麻醉科,贵阳市550004

出　　处：《中华麻醉学杂志》2017年第1期74-76,共3页Chinese Journal of Anesthesiology

基　　金：贵州省科技厅联合基金资助项目（黔科合LH字[2015]7424号）;贵州省大学生创新创业训练计划项目（201510660022）

摘　　要：目的 评价高脂血症因素对患者吸入七氟醚麻醉肺摄取的影响.方法 择期全麻患者103例,性别不限,年龄20～ 50岁,体重指数18～25 kg/m^2,ASA分级Ⅰ或Ⅱ级,静脉注射咪达唑仑0.1 mg/kg、维库溴铵0.1 mg/kg、芬太尼3μg/kg和依托咪酯0.3 mg/kg,气管插管后行机械通气,吸入2％七氟醚（氧流量2 L/min）.记录吸入七氟醚1、3、5、7、10、15、20和30 min（T0～7）时的吸入浓度（Fi）和呼出浓度（Fe≈Fa）,观察结束后根据血脂结果分为对照组（C组）和高脂血症组（H组）,计算两组Fa/Fi比值和达滴定值（Fa/Fi=0.8）所需时间.结果 C组67例,H组36例.与C组比较,H组T2～4时Fa/Fi比值减小,达滴定值所需时间延长（P＜0.05）.结论 高脂血症患者吸入七氟醚麻醉时肺摄取增加,可能与血气分配系数增大有关.Objective To evaluate the effect of hyperlipidemia on pulmonary uptake in the patients inhaling sevoflurane for anesthesia.Methods A total of 103 patients of both sexes,aged 20-50 yr,with body mass index of 18-25 kg/m^2,of American.Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective operation under general anesthesia,were enrolled in the study.Anesthesia was induced with iv midazolam 0.1 mg/kg,vecuronium 0.1 mg/kg,fentanyl 0.l mg/kg and etomidate 0.3 mg/kg.Patients were mechanically ventilated after endotracheal intubation.Patients inhaled 2% sevoflurane for 30 min at an oxygen flow rate of 2 L/min.The inspired concentrations （Fi） and expired concentrations （Fe,Fe≈alveolar concentration [Fa]） of sevoflurane were recorded at 1,3,5,7,10,15,20 and 30 min of inhalation （T0-7）.Patients were divided into either control group group C） or hyperlipidemia group （group H） according to the results of blood lipid levels after the end of observation.The ratio of Fa/Fi and time spent in reaching the titration value （Fa/Fi =0.8） were calculated in each group.Results There were 67 cases in group C and 36 cases in group H.Compared with group C,the Fa/Fi ratio was significantly decreased at 5,7 and 10 min of inhalation,and the time spent in reaching the titration value was prolonged in group H （P 〈 0.05）.Conclusion The pulmonary uptake of sevoflurane is increased,which may be associated with increased blood/gas partition coefficient.

关 键 词：高脂血症 麻醉药 吸入 肺摄取 药代动力学 

分 类 号：R614.2[医药卫生—麻醉学]