七氟醚复合丙泊酚维持麻醉对老年风湿性心脏病患者的应用效果  

Application Effect of Sevoflurane Combined with Propofol Maintenance Anesthesia in Elderly Patients with Rheumatic Heart Disease

作　　者：史琪 宋涛 SHI Qi;SONG Tao(Department of Anesthesiology,Pingdingshan Second People's Hospital,Pingdingshan 467000,Henan,China)

机构地区：[1]平顶山市第二人民医院麻醉科,河南平顶山467000

出　　处：《中国药物滥用防治杂志》2023年第2期214-217,共4页Chinese Journal of Drug Abuse Prevention and Treatment

摘　　要：目的:探讨七氟醚复合丙泊酚维持麻醉对老年风湿性心脏病(Rheumatic Heart Disease,RHD)患者的影响。方法:选取我院2018年12月—2020年12月收治RHD老年患者90例,按照随机数字表法分为丙泊酚组和复合组,各45例。丙泊酚组采用丙泊酚维持麻醉,复合组在此基础上予以七氟醚维持麻醉。比较两组各时间点心肌损伤标志物水平[肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)、超氧化物歧化酶(SOD)、丙二醛(MDA)]、临床时间指标及心脏不良事件(MACE)。结果:两组主动脉开放2、4、6 h的cTnI、CK-MB、MDA水平高于麻醉诱导,SOD水平低于麻醉诱导前,差异有统计学意义(P<0.05),但组间比较,差异无统计学意义(P>0.05);复合组ICU停留时间、机械通气时间、住院时间均短于丙泊酚组,差异有统计学意义(P<0.05);复合组MACE发生率为4.44%,低于丙泊酚组的20.00%,差异有统计学意义(P<0.05)。结论:七氟醚复合丙泊酚与单独应用丙泊酚维持麻醉对老年RHD患者均为安全有效方法,但七氟醚复合丙泊酚术后康复速度较快,并发症较少,应用安全有效。Objective:To investigate the effect of sevoflurane combined with propofol maintenance anesthesia on elderly patients with rheumatic heart disease(RHD).Methods:Ninety elderly patients with RHD admitted to our hospital from December 2018 to December 2020 were selected and divided into a propofol group and a composite group according to the random number table method,with 45 cases each.Propofol was used to maintain anesthesia in the propofol group,and sevoflurane was used to maintain anesthesia in the composite group on this basis.The levels of myocardial injury markers[creatine kinase isoenzyme(CK-MB),troponin](cTnI),superoxide dismutase(SOD),malondialdehyde(MDA)at each time point,clinical time indicators and adverse cardiac events(MACE)were compared between the two groups.Results:The levels of cTnI,CK-MB and MDA at 2,4,6 h after aortic opening in the two groups were higher than those before anesthesia induction,and the level of SOD was lower than that before anesthesia induction,the differences were statistically significant(P<0.05),but there was no significant difference between the two groups(P>0.05).The ICU stay time,mechanical ventilation time and hospitalization time in the combined group were shorter than those in the propofol group,the differences were statistically significant(P<0.05).The incidence of MACE in the combined group was 4.44%,which was lower than 20.00%in the propofol group,and the diference was statistically significant(P<0.05).Conclusion:Both sevofurane with propofol and propofol alone are safe and effective methods for maintaining anesthesia in elderly patients with RHD,but sevoflurane with propofol has faster postoperative recovery,fewer complications,and safe and effective application.

关 键 词：丙泊酚 七氟醚 风湿性心脏病 心肌损伤 

分 类 号：R614[医药卫生—麻醉学]