依托咪酯与丙泊酚在颅脑硬膜外血肿清除术患者中的应用效果比较  

Comparison of effects of Etomidate and Propofol on patients undergoing craniocerebral epidural hematoma removal

作　　者：何燕[1] HE Yan(Department of Anesthesiology of the First People’s Hospital of Shangqiu City,Shangqiu 476100 Henan,China)

机构地区：[1]商丘市第一人民医院麻醉科,河南商丘476100

出　　处：《中国民康医学》2021年第19期119-121,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:比较依托咪酯与丙泊酚在颅脑硬膜外血肿清除术患者中的应用效果。方法:选取78例行血肿清除术的颅脑硬膜外血肿患者为研究对象,按照随机数字表法分为对照组和观察组各39例。对照组采用丙泊酚静脉全身麻醉,观察组采用依托咪酯静脉全身麻醉。比较两组各时间点[麻醉诱导前(T_(0))、插管后(T_(1))、手术开始30 min后(T_(2))和术毕拔管时(T_(3))]血流动力学指标[心率(HR)、平均动脉压(MAP)]水平、脑氧摄取率(CERO_(2))、颈内静脉血氧饱和度(SjvO_(2))和不良反应发生率。结果:T_(1)~T_(3)时,观察组MAP、HR均低于对照组,差异有统计学意义(P<0.05);T_(1)~T_(3)时,观察组SjvO_(2)低于对照组、CERO_(2)高于对照组,差异均有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:依托咪酯与丙泊酚用于行血肿清除术的颅脑硬膜外血肿患者,依托咪酯维持血流动力学稳定的效果优于丙泊酚,但丙泊酚改善脑氧代谢状况的效果更优。Objective:To compare effects of Etomidate and Propofol on patients undergoing craniocerebral epidural hematoma removal.Methods:78 patients with craniocerebral epidural hematoma who underwent hematoma removal were selected as the research objects,and were divided into control group and observation group according to the random number table method,39 cases in each.The control group was given intravenous general anesthesia with Propofol,while the observation group was given intravenous general anesthesia with Etomidate.The hemodynamics index levels[heart rate(HR),mean arterial pressure(MAP)]at each time point[before induction of anesthesia(T_(0)),after intubation(T_(1)),30 minutes after the start of the surgery(T_(2))and at the end of the surgery(T_(3))],the cerebral extraction of oxygen(CERO_(2)),the internal jugular venous oxygen saturation(SjvO_(2))and the incidence of adverse reactions were compared between the two groups.Results:At T_(1)-T_(3),the MAP and HR of the observation group were lower than those of the control group,and the difference was statistically significant(P<0.05).At T_(1)-T_(3),the SjvO_(2) of the observation group was lower than the control group;the CERO_(2) was higher than the control group;and the differences were statistically significant(P<0.05).However,there was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:For the patients with craniocerebral epidural hematoma undergoing hematoma removal,Etomidate is superior to Propofol in maintaining the hemodynamic stability,but Propofol is more effective in improving the cerebral oxygen metabolism.

关 键 词：颅脑硬膜外血肿 依托咪酯 丙泊酚 全身麻醉 脑氧摄取率 颈内静脉血氧饱和度 血流动力学 

分 类 号：R614.2[医药卫生—麻醉学] R722.14[医药卫生—外科学]