判断全麻深度几项参数一致性研究  

The consistent study on several parameters of estimating depth of anesthesia

作　　者：陈学新[1] 涂继善[1] 杨汝[1] 施伟忠[1] 张建荣[2] 杨宝珍[2] 

机构地区：[1]宁夏医学院附属医院麻醉科,银川市750004 [2]宁夏医学院附属医院中心实验室,银川市750004

出　　处：《临床麻醉学杂志》2003年第3期133-135,共3页Journal of Clinical Anesthesiology

基　　金：宁夏回族自治区科委资助项目 (编号 :2 0 0 1 0 2 2 0 4)

摘　　要：目的　观察术中血液动力学与数量化脑电图、心率变异指标、部分应激激素等参数变化是否具有一致性。方法　选择ASAⅠ级 ,剖腹行胆囊切除或并胆总管探查术患者 2 1例 ,用芬太尼、氟哌利多、维库溴铵、丙泊酚诱导 ,吸入安氟醚及调整丙泊酚的泵注速度 ,观察八个时间点各参数的变化。监测收缩压 (SBP)、舒张压 (DBP)、心率 (HR)、双频谱指数 (BIS)、95 %边缘频率 (95 %SEF)、低频 (LF)、高频 (HF)、低高比值 (LF/HF)、心率变异指数 (HRV) ;测血皮质醇 (Cor)、醛固酮 (Ald)、血管紧张素Ⅱ (AⅡ )、胰岛素 (INS)。结果　SBP和DBP相关系数为 0 92 4 ;HR与LF/HF、Cor相关系数分别为 0 6 97,0 6 2 3;BIS和 95 %SEF相关系数为 0 84 8;LF/HF与HRV相关系数为 0 6 5 8;LF与HRV、HF相关系数分别为 0 5 5 7,0 5 31;HF与LF、LF/HF相关系数分别为 0 6 0 2 ,- 0 5 5 5 ;HRV与LF/HF、LF相关系数分别为 0 5 5 9,0 6 5 8;Cor与BIS、95 %SEF相关系数分别为 0 6 6 7,0 5 6 8;ALD与AⅡ相关系数为 0 5 4 9;INS与BIS、95 %SEF、Cor相关系数分别为 0 5 2 8,0 5 11,0 5 0 1。结论　BP、HR、脑电参数、心率变异参数、应激反应指标间无明显的一致性 ;HR和LF/HF、Cor、BIS和 95 %SEF有明显的一致性 ;Objective To investgate the consistency of several objectives in the use of monitors of depth of anesthesia:hemodynamics,quantity electroencephalography,heart rate variability and stress response.Methods Twenty one patients(ASAⅠ)scheduled for elective cholecystectomy was studied.Anesthesia was induced with combination of droperidol,fentanyl,vecuronium and propofol,maintained with inhaling enflurance and continuously pumping propofol(3 4mg·kg -1 ·h -1 ).The parameters of EEG and HRV were recorded(HXD Ⅰ type).At the same time,sampling blood to test cortisol(Cor),aldosterone(Ald),angiotensin Ⅱ(AⅡ) and insulin (INS).Results There were correlation between SBP and DBP ( r= 0 924),HR and L/H( r= 0 697),HR and Cor( r= 0 623),BIS and 95% SEF( r= 0 848),L/H and HRV( r= 0 658),LF and HRV( r= 0 557),LF and HF( r= 0 531),HF and LF( r= 0 602),HF and LF/HF( r= 0 555),HRV and LF/HF( r= 0 559),HRV and LF( r= 0 658),Cor and BIS( r= 0 667),Cor and 95% SEF( r= 0 568),ALD and AⅡ( r= 0 549),INS and BIS ( r= 528),INS and 95%SEF( r= 0 511),INS and Cor( r= 0 501).Conclusions There were not consistent between blood pressure and heart rate,blood pressure and electroencephalogram index,blood pressure and HRV index,blood pressure and stress.There were consistent between HR and L/H,HR and Cor,BIS and 95%SEF,among HRV index,Cor(INS)and BIS(95%SEF),Ald and AⅡ

关 键 词：全麻深度 脑电图 心率变异性 应激反应 一致性 全身麻醉 

分 类 号：R614[医药卫生—麻醉学]