熵指数监测在老年全身麻醉下行腹部手术患者中的应用  

Application of entropy index monitoring for general anesthesia in the elderly patients underwent abdominal surgery

作　　者：朱玉梅[1] ZHU Yu-mei(Department of Anesthesiology,the Fifth People′s Hospital of Shenyang City,Liaoning Province,Shenyang110023,China)

机构地区：[1]沈阳市第五人民医院麻醉科,辽宁沈阳110023

出　　处：《中国当代医药》2020年第13期121-124,共4页China Modern Medicine

摘　　要：目的探讨熵指数监测在老年全身麻醉下行腹部手术患者中的应用。方法选取我院2018年2月~2019年10月收治的60例全身麻醉下行择期腹部手术的老年患者作为研究对象,按照随机数字表法分为C组(n=30)和E组(n=30)。E组根据熵指数调整瑞芬太尼和七氟烷,C组根据血压及心率(HR)调整瑞芬太尼和七氟烷。比较两组患者麻醉前(T0)、诱导后(T1)、插管后(T2)、切皮时(T3)、拔管后(T4)的收缩压(SBD)、舒张压(DBP)、HR以及瑞芬太尼的用量、七氟烷的平均维持剂量、呼吸恢复时间、睁眼时间、拔管时间、满意度及不良反应。结果E组T1时的SBP、DBP、HR均低于T0时,差异有统计学意义(P<0.05);C组T1时的SBP、DBP、HR低于T0时,T3、T4时的SBP、DBP、HR高于T0时,差异有统计学意义(P<0.05)。E组T1时的SBP、DBP、HR均高于C组,T3、T4时的SBP、DBP、HR低于C组,差异有统计学意义(P<0.05)。E组T2、T3、T4时的SBP、DBP、HR与T0时比较,差异无统计学意义(P>0.05);C组T2时的SBP、DBP、HR与T0时比较,差异无统计学意义(P>0.05)。两组T2时的SBP、DBP、HR比较,差异无统计学意义(P>0.05)。E组的呼吸恢复时间、睁眼时间、拔管时间短于C组、麻醉药用量少于C组,满意率高于C组,差异有统计学意义(P<0.05)。E组的恶心、低血压、躁动、认知障碍发生率低于C组,差异有统计学意义(P<0.05)。两组患者的呕吐、术中知晓、心动过缓、呼吸抑制发生率比较,差异无统计学意义(P>0.05)。E组的不良反应总发生率低于C组,差异有统计学意义(P<0.05)。结论熵指数监测应用于全身麻醉下行腹部手术的老年患者中可以有效提高麻醉质量,节约麻醉费用。Objective To explore the application of entropy index monitoring for general anesthesia in the elderly patients underwent abdominal surgery.Methods A total of 60 elderly patients underwent elective abdominal surgery under general anesthesia who were admitted to our hospital from February 2018 to October 2019 were selected as the research objects,and they were divided into group E(n=30)and Group C(n=30)according to random number table method.Group E adjusted Remifentanil and Sevoflurane according to entropy index,group C adjusted Remifentanil and Sevoflurane according to blood pressure and heart rate(HR).The systolic blood pressure(SBP),diastolic blood pressure(DBP),HR at the time before anesthesia(T0),before induction(T1),after induction(T2),during skin incision(T3),after extubation(T4),the dosage of Remifentanil,the average inhalation concentration of Sevoflurane,the time of spontaneous breathing,eye opening,extubation,satisfaction scores,adverse reaction were compared between the two groups.Results The SBP,DBP and HR of group E at T1 were lower than those at T0,the differences were statistically significant(P<0.05).The SBP,DBP and HR in group C at T1 were lower than at T0,the SBP,DBP and HR in group C at T3 and T4 were higher than those at T0,the differences were statistically significant(P<0.05).The SBP,DBP and HR of group E at T1 were higher than those of group C,the SBP,DBP and HR of group E at T3 and T4 were lower than those of group C,the differences were statistically significant(P<0.05).There were no significant differences in SBP,DBP,HR between T2,T3,T4 and T0 in group E(P>0.05).There were no significant differences in SBP,DBP,HR between T0 and T2 in group C(P>0.05).There were no significant differences in SBP,DBP and HR between the two groups at T2(P>0.05).The time of respiratory recovery,eye opening and extubation in Group E were shorter than those in group C,the dosage of anesthetics in Group E was less than that in group C,and the satisfaction rate in Group E was higher than that in group C,the diff

关 键 词：熵指数 老年患者 全身麻醉 麻醉质量 不良反应 

分 类 号：R614.2[医药卫生—麻醉学]