七氟烷对老年患者腹腔镜手术氧化应激与心肌复极的影响研究  

Study on the effect of sevoflurane on oxidative stress and myocardium repolarization of senile patient undergoing laparoscopic surgery

作　　者：王晨光 苏海霞 王春燕[2] WANG Chen-guang;SU Hai-xia;WANG Chun-yan(School of Anesthesia,Shanxi Medical University,Taiyuan 030000,China;不详)

机构地区：[1]山西医科大学麻醉学系,山西太原030000 [2]山西医科大学第一医院麻醉科,山西太原030001

出　　处：《中国医学装备》2022年第3期114-119,共6页China Medical Equipment

基　　金：山西省重点科研项目(2019SP-043)“七氟烷对老年患者腹腔镜手术氧化应激与心肌复极的影响”。

摘　　要：目的:探讨七氟烷对老年患者腹腔镜手术氧化应激与心肌复极的影响。方法:选取医院择期行腹腔镜胆囊切除术的90例老年患者,按随机数表法将其分为1.5%七氟烷(Q1组)、2.5%七氟烷(Q2组)和全凭静脉麻醉的对照组,每组30例。3组患者常规气管插管全身麻醉,分别于麻醉诱导前(T_(0))、七氟烷达到设定浓度后15 min(T_(1))、30 min(T_(2))、45 min(T_(3))、拔管后(T_(4))记录心率(HR)、平均动脉压(MAP)、呼气末二氧化碳分压(P_(et)CO_(2));采用脑电双频指数(BIS)调控镇静深度,均使用12导联心电图(ECG)记录测量QT间期(QT)、Bazett公式校正QT间期(QTcB)、Fridericia公式校正QT间期(QTcF)、QT离散度(QTd)、校正QT离散度(QTcd);比较3组患者不同时刻QT、QTcB、QTcF、QTd及QTcd的变化。结果:Q2组与对照组T_(2)、T_(3)时刻相比MAP均下降,差异有统计学意义(F=5.94,F=3.98;P<0.05);Q2组与对照组T_(1)、T_(2)时刻比HR均减慢,差异有统计学意义(F=4.041,F=4.267;P<0.05)。Q2组T_(2)、T_(3)时刻MAP均下降,T_(1)、T_(2)时刻HR均减慢,与其他时刻比较差异有统计学意义(F=5.169,F=8.302;P<0.05);Q1组、Q2组和对照组T_(2)、T_(3)时刻BIS均降低,与其他时刻比较差异有统计学意义(F=8.068,F=8.302,F=8.119;P<0.05)。T_(1)、T_(2)时刻Q2组QT、QTcB及QTcF均延长,与T_(0)时刻相比差异有统计学意义(F=49.636,F=2.641,F=14.012;P<0.05)。T_(1)、T_(2)时刻Q2组QT、QTcB及QTcF均延长,与对照组相比差异有统计学意义(F_(T1)=51.421,F=3.780,F=12.842;F_(T2)=26.502,F=2.845,F=9.532;P<0.05)。结论:静吸复合麻醉下,2.5%七氟烷维持对QT及其相关指标明显延长,对QTd、QTcd无明显影响。Objective:To explore the effects of sevoflurane on oxidative stress and myocardium repolarization of senile patient who underwent laparoscopic surgery.Methods:Totally 90 senile patients who underwent laparoscopic cholecystectomy were selected.And they were divided into 1.5% sevoflurane group(Q1 group),2.5% sevoflurane group(Q2 group) and control group which only adopted intravenous anesthesia,with 30 cases in each group.All three group adopted conventional trachea cannula and general anesthesia.Heart rate(HR),mean arterial pressure(MAP) and End-Tidal Carbon Dioxide Partial Pressure(P_(et)CO_(2)) pre anesthesia induction(T_(0)),at the 15th min(T_(1)),the 30th min(T_(2)),the 45th min(T_(3)) after sevoflurane concentration reached to the requirement of setting,and after the tube was drawn(T_(4)) were respectively recorded.The bispectral index(BIX) was adopted to adjust the sedation depth.All three groups used 12 leads electrocardiograph(ECG) to record and measure QT interval(QT),QT interval with the correction by Bazett formula(QTcB),QT interval with the correction by Fridericia formula(QTcF),QT dispersion(QTd) and the corrected QT dispersion(QTcd).And the changes of QT,QTcB,QTcF,QTd and QTcd of three groups at different times were compared.Results:The MAPs at T_(2) and T_(3) of Q2 group were significantly lower than those of control group(F=5.94,F=3.98,P<0.05).The HRs at T_(1) and T_(2) of Q2 group were significantly slower than those of control group(F=4.041,F=4.267,P<0.05).The MAPs both T_(2) and T_(3) of Q2 group decreased,and HRs both T_(1) and T_(2) of that geared down,and the differences of those between these times and other times were significant(F=5.169,F=8.302,P<0.05).BISs of T_(2) and T_(3) of each group decreased,and the differences of those between these times and other times were statistically significant(F=8.068,F=8.302,F=8.119,P<0.05).The QT,QTcB and QTcF of Q2 group of T_(1) and T_(2) were prolonged,and the differences of them among T_(1),T_(2) and T_(0) were significant(F=49.636,F=2.641,F=14.012,P

关 键 词：七氟烷 腹腔镜胆囊切除术 校正QT间期 QT离散度 氧化应激 心肌复极 

分 类 号：R614[医药卫生—麻醉学]