依托咪酯联合舒芬太尼对心脏手术患者心搏出量及CO2蓄积量的影响  

Effect of etomidate combined with sufentanil on cardiac output and CO2 accumulation in patients undergoing cardiac surgery

作　　者：代成勇 Dai Chengyong(Anesthesia Department,the First People's Hospital of Huizhou,Huizhou 516000)

机构地区：[1]广东省惠州市第一人民医院麻醉科,516000

出　　处：《中国现代医药杂志》2020年第7期27-30,共4页Modern Medicine Journal of China

摘　　要：目的探讨依托咪酯联合舒芬太尼对心脏手术患者心搏出量及CO2蓄积量的影响。方法选择2018年1月~2020年1月在我院拟行心脏手术的90例患者为研究对象,按照随机数字表法分为A组、B组和C组,各30例,其中A组患者实施常规麻醉,B组单纯采用舒芬太尼进行麻醉,C组则采用依托咪酯联合舒芬太尼进行麻醉,对三组患者不同时间节点的心搏出量、CO2蓄积量、炎症水平以及血流动力学进行比较。结果C组患者术后12h和24h时心搏出量高于其他两组,CO2蓄积量低于其他两组,三组比较差异有统计学意义(P<0.05);三组术前血流动力学指标差异无统计学意义(P>0.05),在术后12h和术后24h时,A组和B组血流动力学指标相对C组以及术前明显降低,差异有统计学意义(P<0.05),而C组术后24h水平几乎接近术前;术后24h,A组和B组TNF-α和IL-6浓度与术前相比,差异有统计学意义(P<0.05),但C组TNF-α和IL-6浓度与术前比较差异无统计学意义(P>0.05),术后12h和术后24h,三组之间TNF-α和IL-6浓度比较差异均有统计学意义(P<0.05)。结论依托咪酯联合舒芬太尼可以有效促进心脏手术患者心搏出量及CO2蓄积量的早期恢复,减轻患者围术期的应激反应和炎症水平。Objective To investigate the effect of etomidate combined with sufentanil on cardiac output and CO2 accumulation in patients undergoing cardiac surgery.Methods A total of 90 patients who planned to undergo cardiac surgery in our hospital from Jan 2018 to Jan 2020 were selected.They were divided into group A(n=30),group B(n=30)and group C(n=30)according to the random number table.Patients in group A received routine anesthesia,patients in group B received simple sufentanil anesthesia,and patients in group C received etomidate combined with sufentanil anesthesia.Cardiac output,CO2 accumulation,inflammatory level and hemodynamics of the three groups at different time points were compared.Results Cardiac output of patients in group C was the highest at 12 h and 24 h after surgery in three groups,while the CO2 accumulation at 12 h and 24 h after surgery was the lowest in three groups,and the difference among the three groups was statistically significant(P<0.05).There was the no statistically significant difference in preoperative hemodynamic data among the three groups(P>0.05).At 12 h and 24 h after surgery,the hemodynamic data of group A and group B were significantly lower than those of group C and preoperation(P<0.05),while the level of group C at 24 h after surgery was almost close to those before surgery.At 24 h after surgery,the concentration of TNF-αand IL-6 in group A and group B were statistically different compared with preoperation(P<0.05),but those in group C had no statistical difference compared with preoperation(P>0.05).The concentration of TNF-αand IL-6 among the three groups were statistically different at 12 h and 24 h after surgery(P<0.05).Conclusion Etomidate combined with sufentanil can effectively promote the early recovery of cardiac output and CO2 accumulation in patients with cardiac surgery,and reduce the perioperative stress response and inflammation level.

关 键 词：依托咪酯 舒芬太尼 心脏手术 心搏出量 CO2蓄积量 炎症反应 

分 类 号：R614[医药卫生—麻醉学]