依托咪酯联合不同剂量纳布啡在无抽搐电休克治疗精神分裂症中的应用价值分析  

Application value of etomidate combined with different doses of nalbuphine in modified electric convulsive therapy of schizophrenia

作　　者：孙明 东桂杰 SUN Ming;DONG Gui-jie(Zaozhuang Mental Health Center,Zaozhuang 277000,China)

机构地区：[1]枣庄市精神卫生中心,277000

出　　处：《中国实用医药》2023年第16期107-110,共4页China Practical Medicine

摘　　要：目的研究依托咪酯联合不同剂量纳布啡在无抽搐电休克治疗(MECT)精神分裂症中的应用价值。方法90例行MECT的精神分裂症患者,采用随机数字表法分为高剂量组、低剂量组和对照组,每组30例。三组均静脉推注依托咪酯,在此基础上,高剂量组静脉推注纳布啡0.1 mg/kg,低剂量组静脉推注纳布啡0.05 mg/kg,对照组静脉推注生理盐水2 ml。比较三组患者麻醉前(T0)、麻醉诱导后(T1)、行MECT 1 min时(T2)、行MECT 5 min时(T3)、行MECT 10 min时(T4)的收缩压(SBP)、舒张压(DBP)和心率(HR)水平,抽搐时间、自主呼吸恢复时间和苏醒时间,注射琥珀胆碱后肌阵挛严重程度,不良反应发生情况。结果T0、T4时,三组SBP、DBP和HR组间两两比较,差异无统计学意义(P>0.05)。T1时,三组DBP和HR组间两两比较,差异无统计学意义(P>0.05);高剂量组SBP低于对照组,差异有统计学意义(P<0.05)。T2时,高剂量组SBP、DBP和HR均明显低于低剂量组和对照组,且低剂量组低于对照组,差异有统计学意义(P<0.05);低剂量组和对照组的SBP、DBP和HR均明显高于本组T0时,差异有统计学意义(P<0.05);高剂量组的SBP、DBP和HR与本组T0时比较,差异无统计学意义(P>0.05)。T3时,高剂量组、低剂量组SBP、DBP均低于对照组,高剂量组SBP低于低剂量组,差异有统计学意义(P<0.05);高剂量组HR低于低剂量组和对照组,差异有统计学意义(P<0.05)。三组抽搐时间、自主呼吸恢复时间和苏醒时间比较,差异无统计学意义(P>0.05)。高剂量组注射琥珀胆碱后肌阵挛严重程度低于低剂量组和对照组,且低剂量组低于对照组,差异有统计学意义(P<0.05)。高剂量组、低剂量组不良反应发生率分别为3.33%、16.67%,明显低于对照组的43.33%,差异有统计学意义(P<0.05);高剂量组、低剂量组不良反应发生率比较,差异无统计学意义(P>0.05)。结论依托咪酯联合纳布啡(0.1 mg/kg)在MECT精神分裂症中能够有效抑Objective To study the application value of etomidate combined with different doses of nalbuphine in modified electric convulsive therapy(MECT)of schizophrenia.Methods A total of 90 cases of schizophrenia patients who had MECT were randomly divided into a high-dose group,a low-dose group and a control group according to the random numerical table,with 30 cases in each group.All three groups were injected with etomidate intravenously,on this basis,the high-dose group received intravenous bolus of nalbuphine 0.1 mg/kg,the low-dose group received intravenous bolus of nalbuphine 0.05 mg/kg,and the control group received intravenous bolus of normal saline 2 ml.Comparison was made on systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)before anesthesia(T0),after anesthesia induction(T1),1 min after MECT(T2),5 min after MECT(T3)and 10 min after MECT(T4),convulsion time,spontaneous breathing recovery time,recovery time,severity of myoclonus after succinylcholine injection,and the adverse reactions among the three groups.Results At T0 and T4,there was no statistically significant difference in SBP,DBP and HR among the three groups(P>0.05).At T1,there was no statistically significant difference in DBP and HR among the three groups(P>0.05).SBP of high-dose group was lower than that of the control group,and the difference was statistically significant(P<0.05).At T2,SBP,DBP and HR in high-dose group were significantly lower than those in low-dose group and control group,and the low-dose group was lower than the control group.The differences were statistically significant(P<0.05).At T2,SBP,DBP and HR in low-dose group and control group were significantly higher than those at T0 in this group,and the difference was statistically significant(P<0.05).At T2,there was no statistically significant difference in SBP,DBP and HR in the high-dose group when compared with those at T0 in this group(P>0.05).At T3,SBP and DBP in high-dose group and low-dose group were lower than those in control group,and SBP in high

关 键 词：依托咪酯 纳布啡 无抽搐电休克治疗 精神分裂症 

分 类 号：R749.3[医药卫生—神经病学与精神病学]