快通道麻醉对心脏手术患者血流动力学、苏醒质量及神经功能的影响  

Effects of fast-track anesthesia on hemodynamics,awakening quality and neurological function in patients undergoing cardiac surgery

作　　者：马瑞芳 黄坤 邓群 MA Ruifang;HUANG Kun;DENG Qun(Department of Anesthesiology,Zhengzhou Seventh People′s Hospital of Henan Province,Zhengzhou,Henan,450000)

机构地区：[1]河南省郑州市第七人民医院麻醉科,河南郑州450000

出　　处：《实用临床医药杂志》2024年第3期90-94,共5页Journal of Clinical Medicine in Practice

摘　　要：目的 探讨快通道麻醉对心脏手术患者血流动力学、苏醒质量及神经功能的影响。方法 选取130例心脏手术患者作为研究对象,采用随机数字表法分为对照组与研究组,每组65例。收集患者的临床资料,比较2组患者的血流动力学指标、苏醒质量、神经功能及术后并发症发生率。结果 研究组患者枸橼酸芬太尼注射液、罗库溴铵用量均低于对照组,差异有统计学意义(P<0.05)。麻醉诱导后、气管插管后,2组患者心率(HR)、平均脉动压(MAP)、心输出量(CO)、心脏指数(CI)、脑电双频指数(BIS)均较麻醉诱导前发生变化,但研究组变化程度低于对照组,差异有统计学意义(P<0.05)。研究组术后恢复呼吸时间、苏醒时间、拔管时间、ICU停留时间、术后住院时间均短于对照组,拔管后躁动发生率低于对照组,差异有统计学意义(P<0.05)。研究组患者动脉开放后180 min的神经元特异性烯醇化酶(NSE)、β淀粉样蛋白(Aβ)水平均低于对照组,差异有统计学意义(P<0.05)。研究组术后并发症总发生率为3.08%,低于对照组的16.92%,差异有统计学意义(P<0.05)。结论 快通道麻醉能够有效稳定心脏手术患者的血流动力学状态,改善患者的苏醒质量及神经功能,并降低术后并发症发生率。Objective To investigate the effects of fast-track anesthesia on hemodynamics,awakening quality,and neurological function in patients undergoing cardiac surgery.Methods A total of 130 patients undergoing cardiac surgery were selected and were randomly divided into control group(n=65) and study group(n=65).The clinical data of the patients were collected,and the hemodynamic parameters,awakening quality,neurological function,and incidence of postoperative complications were compared between the two groups.Results The study group had lower dosages of fentanyl citrate injection and rocuronium bromide compared with the control group(P<0.05).After anesthesia induction and tracheal intubation,the heart rate(HR),mean arterial pressure(MAP),cardiac output(CO),cardiac index(CI),and bispectral index(BIS) were changed compared with before anesthesia induction in both groups,but the degree of change in the study group was less than that in the control group(P<0.05).The study group had shorter postoperative recovery time to breathe,awakening time,extubation time,ICU stay time,and postoperative hospital stay compared with the control group,the incidence of restlessness after extubation was lower in the study group than in the control group(P<0.05).The study group had lower levels of neuron-specific enolase(NSE) and β-amyloid protein(Aβ) at 180 min after arterial cannulation compared with the control group(P<0.05).The total incidence of postoperative complications was 3.08% in the study group,which was lower than 16.92% in the control group(P< 0.05).Conclusion Fast-track anesthesia can effectively stabilize hemodynamics in patients undergoing cardiac surgery,improve awakening quality and neurological function,and reduce the incidence of postoperative complications.

关 键 词：快通道麻醉 心脏手术 血流动力学 苏醒质量 神经功能 

分 类 号：R654.2[医药卫生—外科学] R614[医药卫生—临床医学] R45