依托咪酯与异丙酚在宫外孕失血性休克患者全麻诱导中的临床应用研究  

Comparison of clinical application of etomidate and propofol in induction of general anesthesia in ectopic pregnancy patients with hemorrhagic shock

作　　者：杨永朋 史涛 YANG Yongpeng;SHI Tao(Department of Surgery and Anesthesiology,Central Hospital of Tongchuan Mining Burean,Tongchuan 727099,China)

机构地区：[1]铜川矿务局中心医院手术麻醉科,陕西铜川727099 [2]铜川市人民医院手术麻醉科,陕西铜川727031

出　　处：《陕西医学杂志》2022年第7期799-802,共4页Shaanxi Medical Journal

基　　金：国家自然科学基金资助项目(31300675)。

摘　　要：目的:探究在宫外孕失血性休克患者手术全麻诱导中,使用依托咪酯与异丙酚进行麻醉的临床疗效。方法:选择64例宫外孕失血性休克患者为研究对象,使用随机数字表法将其分为依托咪酯组(32例)和异丙酚组(32例)。两组研究对象均为急诊患者,且均采用腹腔镜手术对患者进行治疗。依托咪酯组全麻诱导:0.05 mg/kg咪唑安定、2.5μg/kg芬太尼、0.2 mg/kg依托咪酯、0.1 mg/kg维库溴铵;异丙酚组麻醉诱导:0.05 mg/kg咪唑安定、2.5μg/kg芬太尼、0.1 mg/kg异丙酚、0.1 mg/kg维库溴铵。①记录并比较两组患者手术时间、拔管时间、清醒时间以及定向恢复力时间等情况;②对两组患者麻醉疗效进行判定;③比较两组患者麻醉诱导前(T_(0))、插管后1 min(T_(1))、插管后3 min(T_(2))的平均动脉压和心率变化情况;④记录并比较两组患者术后发热、静脉血栓以及出血等不良反应的发生情况。结果:①与异丙酚组比较,依托咪酯组患者的拔管时间、清醒时间以及定向恢复力时间均有降低,且组间比较差异具有统计学意义(均P<0.05);②与异丙酚组相比,依托咪酯组患者总体有效率提高,但组间比较差异无统计学意义(P>0.05);③两组患者在麻醉诱导前的平均动脉压以及心率比较差异无统计学意义(均P>0.05);插管后1 min、插管后3 min均有改善,且插管后1 min与插管后3 min两组间平均动脉压和心率比较差异均具有统计学意义(均P<0.05),依托咪酯组明显优于异丙酚组(P<0.05);④依托咪酯组患者术后不良反应如发热、静脉血栓以及出血等不良反应发生率均低于对照组患者,且组间比较差异具有统计学意义(均P<0.05)。结论:在宫外孕失血性休克患者手术全麻诱导中使用依托咪酯具有更好的临床效果,能够明显减少患者拔管时间和苏醒时间,显著改善患者平均动脉压、心率,同时能够减少患者术后不良反应发生率,与异丙酚相比具�Objective:To explore the clinical efficacy of etomidate and propofol for general anesthesia induction in ectopic pregnancy patients with hemorrhagic shock.Methods:A total of 64 ectopic pregnancy patients with hemorrhagic shock were selected as the research objects,and they were divided into etomidate group(32 cases)and propofol group(32 cases)by using random number table method.The subjects of the two groups were all emergency patients,and all patients were treated by laparoscopic surgery.The etomidate group received intravenous injection of 0.05 mg/kg midazolam,2.5μg/kg fentanyl,0.2 mg/kg etomidate and 0.1 mg/kg vecuronium bromide during induction of general anesthesia.The propofol group received intravenous injection of 0.05 mg/kg midazolam,2.5μg/kg fentanyl,0.1 mg/kg propofol and 0.1 mg/kg vecuronium bromide for induction of anesthesia.The operation time,extubation time,awake time and directional recovery time of the two groups were recorded and compared.The anesthesia efficacy of the two groups was judged.The changes of mean arterial pressure and heart rate before anesthesia induction(T_(0)),1 minute after intubation(T_(1)),and 3 minutes after intubation(T_(2))were compared between the two groups.The occurrence of adverse reactions such as postoperative fever,venous thrombosis and bleeding in the two groups were recorded and compared.Results:Compared with the propofol group,the extubation time,awake time and directional recovery time of the etomidate group were all decreased(all P<0.05).Compared with the propofol group,the overall effective rate of the etomidate group was improved(P>0.05).There was no significant difference in mean arterial pressure and heart rate before anesthesia induction between the two groups(P>0.05).The mean arterial pressure and heart rate of the two groups were improved at 1 minute after intubation and 3 minutes after intubation,and the etomidate group was significantly better than the propofol group(all P<0.05).The incidence of postoperative adverse reactions was lower than those i

关 键 词：依托咪酯 异丙酚 宫外孕 失血性休克 全麻诱导 

分 类 号：R714.2[医药卫生—妇产科学]