氨茶碱联合GDFT对老年心功能不全患者麻醉诱导期间循环系统血流动力学变化的影响  

Effect of aminophylline and GDFT on hemodynamic changes of circulatory system during anesthesia induction in elderly patients with cardiac insufficiency

作　　者：杨艳[1] 郭正轩[1] 刘晶涛[1] YANG Yan;GUO Zheng-xuan;LIU Jing-tao(Department of Anesthesi-ology,Anyang District Hospital,Anyang 455000,Henan,China)

机构地区：[1]濮阳市安阳地区医院麻醉科,河南濮阳455000

出　　处：《广东医学》2021年第4期436-439,共4页Guangdong Medical Journal

基　　金：濮阳市科技计划项目(2017KJ081)。

摘　　要：目的探讨氨茶碱联合目标导向液体治疗(GDFT)对老年心功能不全患者麻醉诱导期间循环系统血流动力学变化的影响及安全性。方法选取接受治疗的老年心功能不全患者166例,按随机数字表法分成两组。对照组(83例)采用基本输液方式治疗,观察组(83例)采用氨茶碱联合GDFT。通过不同时间点对两组患者的心排量(CO)、心脏指数(CI)、心率(HR)、平均动脉压(MAP)等指标进行对比;记录两组患者麻醉药的剂量以及诱导期间血管活性药的使用次数和用量;处理缓慢心律失常的次数以及阿托品的使用量。结果两组患者麻醉药的剂量对比,差异无统计学意义(P>0.05)。观察组与诱导前相比,诱导时CO、CI升高(P<0.05);插管后5 min、插管后15 min对照组CO、CI降低(P<0.05);观察组与对照组相比,诱导时、插管后5 min、插管后15 min CO、CI升高(P<0.05);两组患者在整个麻醉过程HR、MAP比较差异无统计学意义(P>0.05),观察组与对照组相比,血管活性药物使用剂量及心律失常次数明显减少,差异有统计学意义(P<0.05)。结论氨茶碱联合GDFT对老年心功能不全患者麻醉诱导期间循环系统血流动力学变化有积极影响,使患者循环系统血流动力学稳定,降低患者其他并发症,治疗安全性较高。Objective To investigate the efficacy and safety of aminophylline combined with goal-directed fluid therapy(GDFT)on hemodynamic changes of circulatory system during anesthesia induction in elderly patients with cardiac insufficiency.Methods A total of 166 patients with cardiac insufficiency were randomly divided into the control group(83 cases)and treated with basic infusion.The observation group(83 cases)were treated with aminophylline and GDFT.The cardiac output(CO),cardiac index(CI),heart rate(HR),and mean arterial pressure(MAP)of the two groups of patients were compared at different time points.The use of anesthetics and the blood vasoactive agents during induction were recorded.The times of treat bradycardic arrhythmias and the amount of atropine used were also recorded.Results There was no significant difference in doses of anesthetics between the observation group and the control group(P>0.05).Significant increases in CO and CI were observed in observation group after induction,while they were significantly reduced 5 minutes and 15 minutes after intubation(P<0.05).Compared with the control group,CO and CI were significantly increased during induction,5 minutes after intubation and 15 minutes after intubation in the observation group(P<0.05).There was no significant difference in HR or MAP between the two groups(P>0.05).Compared with the control group,the dose of vasoactive drugs and the number of arrhythmia were significantly reduced(P<0.05).Conclusion Aminophylline combined with GDFT has a positive impact on the hemodynamic changes of the circulatory system during the induction of anesthesia in elderly patients with cardiac insufficiency,stabilizes the patient′s circulatory system hemodynamics,reduces complications,and is safer to use.

关 键 词：氨茶碱 目标导向液体治疗 心功能不全 麻醉诱导 

分 类 号：R541[医药卫生—心血管疾病] R45[医药卫生—内科学]