左心室舒张功能障碍对全身麻醉诱导后严重低血压发生率的影响  

Effect of left ventricular diastolic dysfunction on incidence of severe hypotension after anesthesia induction

作　　者：沈俊辉 陈翠平 梁广彬 符莉莉 梁婷 李志艺 SHEN Jun-hui;CHEN Cui-ping;LIANG Guang-bin;FU Li-li;LIANG Ting;LI Zhi-yi(Department of Anesthesiology,Affiliated Hospital of Guangdong Medical University,Zhanjiang,Guangdong 524001,China;Department of Orthopedic Surgery,Affiliated Hospital of Guangdong Medical University, Zhanjiang,Guangdong 524001,China;Department of Ultrasound,Affiliated Hospital of Guangdong Medical University,Zhanjiang,Guangdong 524001,China)

机构地区：[1]广东医科大学附属医院麻醉科,广东湛江524001 [2]广东医科大学附属医院骨科中心,广东湛江524001 [3]广东医科大学附属医院超声科,广东湛江524001

出　　处：《岭南心血管病杂志》2019年第5期571-574,共4页South China Journal of Cardiovascular Diseases

基　　金：湛江市非资助科技攻关计划项目（项目编号：2017B01065）

摘　　要：目的探讨左心室舒张功能障碍对围全身麻醉诱导期血流动力学的影响。方法收集2017年7月至2017年12月于广东医科大学附属医院拟行非心血管手术的全身麻醉患者24例为研究对象。对拟行全身麻醉的心脏功能正常及左心室舒张功能障碍2组患者进行诱导前、诱导后及气管插管后血压、心率的比较。结果全身麻醉诱导后舒张功能障碍组收缩压<80mmHg(1mmHg=0.133kPa)的发生率、舒张压<50mmHg的发生率、收缩压<80mmHg或舒张压<50mmHg的发生率均较心脏功能正常组明显升高,差异有统计学意义(58.3%vs.16.7%,P<0.05;66.7%vs.25.0%,P<0.05;66.7%vs.25.0%,P<0.05)。气管插管后舒张功能障碍组心率较心脏功能正常组明显升高,差异有统计学意义[(75±3)次/minvs.(89±5)次/min,P<0.05]。结论左心室舒张功能障碍患者在全身麻醉诱导后更易发生严重低血压,这将会导致心肌缺血等心脏不良事件的发生。Objectives To explore the effect of left ventricular diastolic dysfunction on hemodynamics during the induction of general anesthesia.Methods Totally 24 patients underwent non-cardiovascular surgery with induction of general anesthesia from July 2017 to December 2017 in Affiliated Hospital of Guangdong Medical University were selected.Blood pressure and heart rate of the patients with normal heart function or left ventricular diastolic dysfunction before and after induction and after endotracheal intubation were compared.Results Incidence of hypotension with systolic blood pressure lower than 80 mmHg(1 mmHg=0.133 kPa),diastolic blood pressure lower than 50 mmHg,systolic blood pressure lower than 80 mmHg or diastolic blood pressure lower than 50 mmHg in the diastolic dysfunction group after induction of general anesthesia were significantly higher than those in normal heart function group(58.3% vs.16.7%,P<0.05;66.7% vs.25.0%,P<0.05;66.7% vs.25.0%,P<0.05).After endotracheal intubation,heart rate of the diastolic dysfunction group was significantly higher than that of normal heart function group[(75±3)bit/min vs.(89±5)bit/min,P<0.05)].Conclusions Patients with left ventricular diastolic dysfunction are more likely to have severe hypotension after induction of general anesthesia,which will lead to myocardial ischemia and other adverse cardiac events.

关 键 词：心力衰竭 左心室舒张功能障碍 全身麻醉 诱导 血压 心率 

分 类 号：R541.6[医药卫生—心血管疾病]