精准医学理念下靶控输注模式在心脏外科手术麻醉中的应用  

Application of target controlled infusion mode under the concept of precision medicine in anesthesia for patients undergoing cardiac surgery

作　　者：王凯 王俊伟 李金瑞 WANG Kai;WANG Junwei;LI Jinrui(Department of Anesthesiology,the Seventh People′s Hospital of Zhengzhou,Zhengzhou 450000,China)

机构地区：[1]郑州市第七人民医院麻醉科,郑州450000

出　　处：《华夏医学》2025年第2期85-90,共6页Acta Medicinae Sinica

基　　金：河南省医学科技攻关项目(LHGJ202102267)。

摘　　要：目的观察精准医学理念下的把控输注模式在心脏外科手术患者麻醉中的应用效果。方法选取115例心脏外科手术患者,按照随机数字表法分为常规组57例和把控组58例。常规组实施常规全身麻醉,把控组实施基于精准医学理念的把控输注模式麻醉,比较两组患者的围手术期血流动力学指标、临床指标、麻醉药物使用情况及麻醉相关不良反应发生情况。结果在不同麻醉方案下,两组患者麻醉维持10 min后(T1)的心率(HR)、平均动脉压(MAP)均高于常规组,差异具有统计学意义(P<0.05);把控组的手术耗时、机械通气时间均短于常规组,出血量、输液量均少于常规组,术中体外循环率、术后镇痛补救率均低于常规组(P<0.05);把控组的丙泊酚用量、瑞芬太尼用量、右美托咪定用量、罗库溴铵用量均少于常规组(P<0.05);把控组的麻醉相关不良反应发生率低于常规组(P<0.05)。结论精准医学理念下的把控输注模式有利于稳定心脏外科手术患者围手术期血流动力学,对降低手术风险、促进术后恢复、减少麻醉维持用药量并降低麻醉相关不良反应发生风险均有积极意义。Objective To observe the application effect of controlled infusion anesthesia mode under the concept of precision medicine in patients undergoing cardiac surgery.Methods 115 patients undergoing cardiac surgery were selected and randomly divided into the conventional group of 57 patients and precision medicine-based controlled infusion group(hereinafter referred to as the controlled infusion group)of 58 patients using a random number table method.The conventional group were received routine general anesthesia,while the controlled infusion group were received controlled infusion anesthesia based on precision medicine concepts.The perioperative hemodynamic indicators,clinical indicators,anesthesia drug usage,and incidence of anesthesia-related adverse reactions were compared between the two groups.Results Under different anesthesia regimens,the heart rate(HR)and mean arterial pressure(MAP)of both groups of patients after 10 min of anesthesia maintenance(T1)were higher than those of the control group,showing a statistically significant difference(P<0.05).The surgical time and mechanical ventilation time in the controlled infusion group were shorter than those in the conventional group,and the bleeding volume,infusion volume,intraoperative extracorporeal circulation time,and postoperative pain relief rate were all lower or better in the controlled infusion group compared to the conventional group(P<0.05).The dosages of propofol,remifentanil,dexmedetomidine,and rocuronium in the controlled infusion group were all lower than those in the conventional group(P<0.05).The incidence of anesthesia-related adverse reactions in the controlled infusion group was lower than that in the conventional group(P<0.05).Conclusion The controlled infusion anesthesia mode under the concept of precision medicine is beneficial for stabilizing the perioperative hemodynamics of patients undergoing cardiac surgery,reducing surgical risks,promoting postoperative recovery,decreasing anesthesia maintenance dosage,and lowering the risk of anesthesi

关 键 词：心脏外科手术 精准医学理念 把控输注模式 血流动力学 麻醉安全性 

分 类 号：R614[医药卫生—麻醉学]