环泊酚在重度抑郁症患者无抽搐电休克治疗中的效果观察  

Clinical efficacy of ciprofol in modified electroconvulsive therapy for the treatment of major depressive disorder in patients

作　　者：孔鹏杰 吕洁萍[2] Kong Pengjie;Lyu Jieping(Department of Anesthesiology,Affiliated Hospital of Shanxi University of Traditional Chinese Medicine,Taiyuan 030024,Shanxi Province,China;Department of Anesthesiology,First Hospital of Shanxi Medical University,Taiyuan 030001,Shanxi Province,China)

机构地区：[1]山西中医药大学附属医院麻醉科,太原030024 [2]山西医科大学第一附属医院麻醉科,太原030001

出　　处：《中国基层医药》2024年第8期1121-1125,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的:观察环泊酚在重度抑郁症患者无抽搐电休克(MECT)治疗中的临床应用效果。方法:选择山西医科大学第一医院精神科2022年11月至2023年3月应用MECT治疗的重度抑郁症患者60例,年龄范围18~60岁,美国麻醉医师协会(ASA)分级Ⅰ~Ⅱ级的患者60例,男31例,女29例,身体质量指数(BMI)为18~30 kg/m^(2),病程3个月至5年。该研究为前瞻性研究,采用随机数字表法分为观察组(环泊酚+琥珀酰胆碱麻醉)和对照组(丙泊酚+琥珀酰胆碱麻醉)。比较两组入室麻醉前(T_(0))、麻醉后(T_(1))、电抽搐即刻(T_(2))、电抽搐结束后(T_(3))的生命体征,包括心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_(2))等。记录两组的呼吸恢复时间(静脉注射完琥珀酰胆碱至自主呼吸开始恢复的时间)和意识恢复时间(静注完环泊酚/丙泊酚至意识开始恢复的时间)、麻醉药物追加情况、血管活性药物应用情况、不良反应发生情况。结果:与T_(0)相比,两组T_(1)时MAP均降低,T_(2)、T_(3)时MAP均升高,T_(1)、T_(2)、T_(3)与T_(0)时相比MAP的差异均有统计学意义[观察组T_(0):(84.11±8.69)mmHg(1 mmHg=0.133 kPa),T_(1):(78.18±8.39)mmHg,T_(2):(99.28±12.42)mmHg,T_(3):(87.31±8.66)mmHg;对照组T_(0):(86.33±10.99)mmHg,T_(1):(75.93±9.51)mmHg,T_(2):(100±13.3)mmHg,T_(3):(93.47±12.27)mmHg,均P<0.05]。HR值组间差异均无统计学意义(均P>0.05)。观察组T_(0)到T_(1)时的MAP波动小于对照组同时段的波动,而T_(2)到T_(3)波动差对照组小于观察组。观察组的意识恢复时间显著短于对照组[观察组:(8.76±0.59)min,对照组:(9.4±0.64)min;t=-4.07,P<0.05)。观察组注射痛发生率明显低于对照组[观察组:0,对照组:30.00%(9/30)](χ^(2)=8.36,P<0.05),两组患者的呼吸恢复时间、头痛、低血压、分泌物增多、术后恶心呕吐及血管活性药物使用等差异均无统计学意义(均P>0.05)。结论:环泊酚用于MECT治疗时可达到良好的麻醉效果,同时患者血流动Objective To investigate the clinical efficacy of ciprofol in modified electroconvulsive therapy for the treatment of major depressive disorder in patients.Methods A total of 60 patients with major depressive disorder who received modified electroconvulsive therapy at the Department of Psychiatry,First Hospital of Shanxi Medical University,from November 2022 to March 2023 were included in this study.They were aged 18-60 years and classified as American Society of Anesthesiologists gradesⅠ-Ⅱ.The patient cohort consisted of 31 males and 29 females,with a body mass index of 18-30 kg/m^(2).The disease duration varied from 3 months to 5 years.This study was designed as a prospective study.All included patients were assigned to observation(ciprofol+succinylcholine)and control(propofol+succinylcholine)using the digital number table method.Vital signs,including heart rate,mean arterial pressure,and blood oxygen saturation,were compared between the two groups at four time points:before anesthesia(T_(0)),after anesthesia(T_(1)),immediately after electroconvulsive therapy(T_(2)),and after the completion of electroconvulsive therapy(T_(3)).The time to recover spontaneous breathing(from intravenous injection of succinylcholine to the onset of spontaneous breathing),the time to recover consciousness(from intravenous injection of ciprofol/propofol to the onset of consciousness),the need for additional anesthetic drugs,the use of vasoactive medications,and the occurrence of adverse reactions were recorded in each group.Results Compared with T_(0),both groups exhibited a decrease in mean arterial pressure at T_(1) and an increase at T_(2) and T_(3).The differences in mean arterial pressure between T_(1),T_(2),T_(3),and T_(0) were statistically significant[observation group:T_(0):(84.11±8.69)mmHg(1 mmHg=0.133 kPa),T_(1):(78.18±8.39)mmHg,T_(2):(99.28±12.42)mmHg,T_(3):(87.31±8.66)mmHg;control group:T_(0):(86.33±10.99)mmHg,T_(1):(75.93±9.51)mmHg,T_(2):(100±13.3)mmHg,T_(3):(93.47±12.27)mmHg,all P<0.05].There was no statist

关 键 词：抑郁症 电休克 心率 动脉压 血氧测定法 环泊酚 

分 类 号：R749.4[医药卫生—神经病学与精神病学]