病毒性肝硬化对丙泊酚全身麻醉下行宫腔镜术的影响  

Effect of viral cirrhosis on hysteroscopy under general anesthesia with propofol

作　　者：解东明 邓友明[1] 刘婷婷 XIE Dong-ming;DENG You-ming;LIU Ting-ting(Department of Anesthesiology,Nanjing Second Hospital/Nanjing Hospital,Nanjing University of Chinese Medicine,Nanjing 210000,Jiangsu Province,China)

机构地区：[1]南京市第二医院、南京中医药大学附属南京医院麻醉科,江苏南京210000

出　　处：《中国临床药理学杂志》2023年第3期341-344,共4页The Chinese Journal of Clinical Pharmacology

基　　金：江苏省基础研究计划(自然科学基金)面上研究基金资助项目(BK2011341)。

摘　　要：目的 观察病毒性肝硬化对丙泊酚靶控输注Schnider模式下宫腔镜术患者体动反应半数有效效应室靶浓度(EC50)的影响。方法 将全身麻醉下行宫腔镜术患者分为病毒性肝硬化患者(记为试验组)和非肝硬化且肝功能正常患者(记为对照组)。2组患者均行丙泊酚靶控输注Schnider模式下宫腔镜术,初始效应室靶浓度设为5.0μg·mL^(-1),浓度阶梯设置为0.5μg·mL^(-1)。比较2组丙泊酚输注过程中不同警觉/镇静观察评分(OAA/S)时刻的动脉压和心率,体动反应EC50,以及药物不良反应的发生情况。结果 最终试验组和对照组分别入组82和68例,试验过程中无患者脱落。试验组在OAA/S评分为5,4,3,2和1分时的平均动脉压分别为(92.26±8.72),(89.09±7.73),(87.19±7.25),(84.08±7.11)和(83.14±6.86)mmHg,对照组分别为(91.07±9.14),(87.81±8.02),(85.27±7.98),(82.01±6.24)和(81.13±6.05)mmHg;试验组在OAA/S评分为5,4,3,2和1分时的心率分别为(81.39±9.14),(83.12±9.50),(78.03±7.98),(75.21±6.53)和(72.19±6.92)beat·min^(-1),对照组分别为(80.45±9.26),(82.01±9.24),(79.59±8.26),(77.05±7.02)和(74.25±7.18)beat·min^(-1),在OAA/S评分相同时,2组间的平均动脉压和心率比较,差异均无统计学意义(均P>0.05)。试验组和对照组的体动反应EC50分别为3.75和4.72μg·mL^(-1),差异有统计学意义(P<0.01)。试验组的药物不良反应主要有恶心呕吐、头晕、低血压和窦性心动过缓,对照组的药物不良反应主要有恶心呕吐、头晕和低血压。试验组与对照组的总药物不良反应发生率分别为8.54%和5.88%,差异无统计学意义(P>0.05)。结论 病毒性肝硬化会降低宫腔镜术患者靶控输注Schnider模式下丙泊酚的EC_(50),增强体动效力,故建议适当降低病毒性肝硬化患者药物靶浓度。Objective To observe the effect of viral cirrhosis on 50% effective ventricular target concentration(EC50) of propofol in hysteroscopy under Schnider mode. Methods The patients undergoing hysteroscopy under general anesthesia were selected, including patients with viral cirrhosis(treatment group), patients with normal liver function without cirrhosis(control group). Patients in both groups received hysteroscopy under Schnider mode of target-controlled infusion of propofol. Initial effector site concentration was set as 5.0 μg·mL^(-1), and the concentration step was set as 0.5 μg·mL^(-1). The mean arterial pressure and heart rate at different points of observer assessment of sedation(OAA/S) during propofol infusion, the EC50of body movements and adverse drug reactions were compared between the two groups.Results The treatment group and control groupswere enrolled 82 and 68 cases, respectively, and no patients fell off during the trial. The mean arterial pressures of thetreatment group at 5, 4, 3, 2, and 1 points were( 92. 26 ± 8. 72),( 89. 09 ± 7. 73),( 87. 19 ± 7. 25),(84. 08 ± 7. 11) and( 83. 14 ± 6. 86) mmHg, control group were( 91. 07 ± 9. 14),( 87. 81 ± 8. 02),(85. 27 ± 7. 98),(82. 01 ± 6. 24) and(81. 13 ± 6. 05) mmHg, differences were not statistically significant( allP> 0. 05). The heart rates of the treatment group at 5, 4, 3, 2 and 1 points were(81. 39 ± 9. 14),(83. 12 ± 9. 50),(78. 03 ± 7. 98),(75. 21 ± 6. 53) and(72. 19 ± 6. 92) times min^(-1), those of control group were(80. 45 ± 9. 26),(82. 01 ± 9. 24),(79. 59 ± 8. 26),(77. 05 ± 7. 02) and(74. 25 ± 7. 18) times·min^(-1), the differences were notstatistically significant(allP> 0. 05). The EC50of body movements in the treatment group and the control group were3. 75 and 4. 72 μg·mL^(-1)with significant difference(P< 0. 05). The adverse drug reactions of treatment group werenausea and vomiting, dizziness, hypotension and sinus bradycardia, while those in the control group were nausea andvomiting, dizziness and hypotension. The i

关 键 词：丙泊酚 宫腔镜术 肝硬化 半数有效效应室靶浓度 

分 类 号：R971.2[医药卫生—药品]