静吸复合全麻对不同基础血压水平患者术中血流动力学稳定性和应激反应的影响对比  被引量:6

Comparison of the effects of Intravenous Inhalation Combined with general anesthesia on hemodynamic stability and stress response in patients with different baseline blood pressure levels

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作  者:罗锋[1] 谭东霞 Luo Feng;Tan Dong-xia(Department of Anesthesiology,Hankou Hospital,Wuhan 430000,China)

机构地区:[1]武汉市汉口医院麻醉科

出  处:《湖南师范大学学报(医学版)》2019年第5期109-113,共5页Journal of Hunan Normal University(Medical Sciences)

摘  要:目的:对比分析不同基础血压水平的静吸复合全麻患者血流动力学稳定性和应激反应相关指标,初步探讨不同基础血压水平患者在静吸复合全麻当中的监测重点及注意事项,为麻醉手术更加安全及高效的开展提供参考依据.方法:于2015年9月~2018年2月采用病例抽样的方法选取本院择期进行静吸复合全麻的手术患者;血流动力学稳定性的监测指标为心率;应激反应的监测指标包括肾上腺素、去甲肾上腺素、白介素-6(IL-6)以及皮质醇,其中肾上腺素、去甲肾上腺素及皮质醇的定量分析采用高效液相色谱法,IL-6的定量分析采用ELISA法,结果于不同光波长下进行检测.结果:高血压Ⅱ级组及高血压Ⅲ级组所有监测时刻的心率、血液比粘度、肾上腺素、去甲肾上腺素、IL-6、皮质醇水平均显著高于其他组,且高血压Ⅲ级组显著高于高血压Ⅱ级组;此外高血压Ⅰ级组在手术开始后20min及手术结束时刻心率、血液比粘度、肾上腺素、去甲肾上腺素水平显著高于低血压组和正常血压组.结论:基础血压水平较高与血流稳定性变差以及应激反应增强存在一定的因果关联,而在静吸复合全麻的过程中则进一步增大了这种关联的密切性.Objective To compare and analyze the hemodynamic stability and stress response of patients with different baseline blood pressure levels under intravenous-inhalation combined general anesthesia, and to preliminarily explore the monitoring focus and precautions of patients with different baseline blood pressure levels under intravenous-inhalation combined general anesthesia, so as to provide a reference for safer and more efficient anesthesia operation. Methods From September 2015 to February 2018, patients undergoing selective intravenous inhalation combined general anesthesia in our hospital were selected by case sampling method. The monitoring indexes of hemodynamic stability were heart rate. The monitoring indexes of stress reaction included adrenaline, noradrenaline, interleukin-6(IL-6) and cortisol. The quantitative analysis of adrenaline, noradrenaline and cortisol was carried out. High performance liquid chromatography and ELISA were used for quantitative analysis of IL-6. The results were detected at different light wavelengths. Results The heart rate, blood specific viscosity, adrenaline, norepinephrine, IL-6 and cortisol levels at all monitoring time in the hypertensive grade Ⅱ group and the hypertensive grade Ⅲ group were significantly higher than those in the other groups, and the hypertensive grade Ⅲ group was significantly higher than that in the hypertensive grade Ⅱ group. In addition, the heart rate, blood specific viscosity, adrenaline and cortisol levels in the hypertensive grade I group were significantly higher than those in the hypertensive grade Ⅱ group at 20 minutes after operation and at the end of operation. The level of adrenaline was significantly higher than that of hypotension group and normal blood pressure group. Conclusion There is a causal relationship between the high basal blood pressure level and the worsening of blood flow stability and the enhancement of stress response, which is further enhanced in the course of Intravenous Inhalation Combined with general anesthes

关 键 词:静吸复合全麻 基础血压 血流动力学 应激反应 

分 类 号:R614.2[医药卫生—麻醉学]

 

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