七氟醚吸入麻醉对急性颅内出血患者呼吸循环系统及脑功能的影响  

Effects of Sevoflurane inhalation anesthesia on respiratory and circulatory system and brain function in patients with acute intracranial hemorrhage

作　　者：梁艳宁 周伟[1] LIANG Yan-ning;ZHOU-Wei(Department of Surgical Anesthesiology,Puyang Oilfield General Hospital,Puyang,Henan 457001,China)

机构地区：[1]濮阳市油田总医院手术麻醉科,河南濮阳457001

出　　处：《医药论坛杂志》2021年第1期13-16,21,共5页Journal of Medical Forum

基　　金：河南省2019年医学科技攻关计划项目(SB201904016)。

摘　　要：目的分析七氟醚吸入麻醉对急性颅内出血患者呼吸循环系统及脑功能的影响。方法本次研究纳入对象为濮阳市油田总医院自2018年9月—2019年12月收治的急性颅内出血患者,按纳入、排除标准筛选出67例患者,以随机数字表法分为观察组(n=33)与对照组(n=34),对照组应用异丙酚+瑞芬太尼,观察组给予七氟醚+瑞芬太尼;将两组患者麻醉前后呼吸循环系统、脑功能相关指标进行统计分析,以明确七氟醚吸入麻醉对急性颅内出血患者呼吸循环系统及脑功能的影响。结果经统计学分析发现,两组患者麻醉起效时间对比无统计学意义(P>0.05),但观察组患者睁眼时间、呼吸恢复时间及定向力恢复时间均较对照组短,且对比差异有统计学意义(P<0.05);同时,两组患者麻醉前呼吸频率(RR)、每分钟有效通气量(MV)、心律(HR)、平均动脉压(MAP)及血氧饱和度(SpO2)等对比差异无统计学意义(P>0.05),麻醉诱导后各指标水平均有轻微波动,但观察组RR、MV、MAP及SpO2的波动幅度小于对照组,对比差异有统计学意义(P<0.05);且两组患者在麻醉诱导前(T0)、插管后即刻(T1)的THRR水平对比无差异(P>0.05),打开颅骨前即刻(T2)及开始缝皮时(T3)患者THRR水平均有波动,但观察组患者THRR水平在T2、T3时间节点时波动幅度小于对照组,THRR水平较对照组优,对比差异有统计学意义(P<0.05);而观察组患者喉痉挛、咳嗽、躁动、低血压、恶性呕吐等麻醉相关并发症观察组总发生率为12.12%,显著低于对照组的32.15%,对比差异有统计学意义(P<0.05)。结论七氟醚吸入麻醉对急性颅内出血患者呼吸循环系统及脑功能的影响较小,且发生喉痉挛、咳嗽、躁动、低血压、恶性呕吐等麻醉相关并发症的风险相对较低。Objective To analyze the effects of sevoflurane inhalation anesthesia on respiratory and circulatory system and brain function in patients with acute intracranial hemorrhage.Methods This study included patients in our hospital from September 2018 to December 2019,the patients of acute intracranial hemorrhage, as the standard selected 67 patients, and according to random number table method they were divided into observation group(n=33) and control group(n=34), control group were given propofol + fentanyl, observation group was given sevoflurane + fentanyl. The respiratory and circulatory system and brain function of the two groups of patients before and after anesthesia were statistically analyzed, to determine the effect of sevoflurane inhalation anesthesia on respiratory and circulatory system and brain function of the patients with acute intracranial hemorrhage.Results Through statistical analysis, it was found that there was no statistical significance in the comparison of the onset time of anesthesia between the two groups(P>0.05), but the observation group had shorter duration of eye opening, respiratory recovery and directional force recovery than those of the control group, and the difference was statistically significant(P<0.05). At the same time, two groups of patients before anesthesia breathing rate(RR), effective per minute ventilation(MV), heart rate(HR), mean arterial pressure(MAP) and blood oxygen saturation(SpO2), there was no statistical significance(P>0.05), the difference compared to the index level after anesthesia induction have slight fluctuations, but the observation group of RR, MV, MAP and SpO2 fluctuation amplitude were less than those of the control group, the difference was statistically significant(P<0.05);And two groups of patients before anesthesia induction(T0), immediately after intubation(T1) THRR contrast level no difference(P>0.05), before open the skull(T2) and immediately began to sew leather(T3) THRR level when patients have fluctuations, but the observation group of patien

关 键 词：七氟醚 急性颅内出血 呼吸循环系统 脑功能 

分 类 号：R614[医药卫生—麻醉学]