丙泊酚和琥珀胆碱对食管下括约肌压力和食管胃屏障压的影响  

Effects of propofol and succinylcholine on the pressure of lower esophageal sphincter and esophagogastric barrier pressure

作　　者：曹妍婷[1] 张艳丽[2] 李昭[1] 王思[1] 赵诗斌[1] CAO Yan-ting;ZHANG Yan-li;LI Zhao(Department of Anesthesiology,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院麻醉科,北京100029 [2]中日友好医院消化内科,北京100029

出　　处：《中日友好医院学报》2023年第1期3-6,17,F0002,共6页Journal of China-Japan Friendship Hospital

摘　　要：目的:探讨麻醉诱导过程中丙泊酚和琥珀胆碱对食管下括约肌(LES)压力和食管胃屏障压(BRP)的影响。方法:22例拟行择期手术的患者参与了本研究,麻醉诱导采用丙泊酚和琥珀胆碱。应用高分辨率固态测压(HRM)监测LES压力和BRP的变化。结果:与基础值相比,丙泊酚增加呼气末(P<0.01,95%CI:3.24~9.27)和吸气末(P<0.05,95%CI:0.01~5.52)LES压力,差异有显著性。琥珀胆碱对呼气末LES压力没有影响,但使吸气末LES压力降低,与基础值相比差异有显著性(P<0.01,95%CI:-11.22~-2.28)。与基础值相比,应用丙泊酚后呼气末(P>0.05,95%CI:-3.71~4.07)及吸气末(P>0.05,95%CI:-3.86~4.84)BRP差异均无显著性。应用琥珀胆碱后,与基础值相比吸气末BRP下降,差异有显著性(P<0.01,95%CI:-12.16~-3.71)。结论:丙泊酚显著增加LES压力,但对BRP无显著影响,不会增加胃内容物反流风险。琥珀胆碱显著降低吸气末LES压力和BRP,增加了胃内容物反流风险。Objective:To investigate the effects of propofol and succinylcholine on the pressure of lower esophageal sphincter(LES)and esophagogastric barrier pressure(BRP)in patients during anesthesia induction.Methods:Twenty-two patients participated in the study.Propofol and succinylcholine were used for anesthesia induction.High-resolution solid-state manometry(HRM)was used to monitor the LES pressure and BRP.Results:Compared with the base value,propofol could statistically significantly increase the LES pressure in end expiration(P<0.01,95%CI:3.24~9.27) and in end inspiration(P<0.05,95%CI:0.01~5.52).Succinylcholine had no effect on the LES pressure in end expiration,but reduced the LES pressure in end inspiration.Compared with the basic value,the difference was significant(P<0.01,95%CI:-11.22~-2.28).No significant difference in BRP was observed after propofol application compared with the basic value in end expiration(P>0.05,95%CI:-3.71~4.07)and in end inspiration(P>0.05,95%CI:-3.86~4.84).After the application of succinylcholine,BRP decreased in end inspiration.Compared with the basic value,the difference was significant(P<0.01,95%CI:-12.16~-3.71).Conclusion:Propofol significantly increased the LES pressure,but had no effect on BRP,and did not increase the risk of gastric contents reflux.Succinylcholine significantly reduced the LES pressure and BRP in end inspiration,and increased the risk of gastric contents reflux.

关 键 词：食管下括约肌 丙泊酚 琥珀胆碱 

分 类 号：R614.2[医药卫生—麻醉学]