全麻诱导中静注羟考酮对肺癌根治术患者血流动力学及应激反应的影响

发布时间：2018-03-27 17:47

本文选题：羟考酮　切入点：舒芬太尼　出处：《山东医药》2017年23期

【摘要】：目的观察全麻诱导中静注羟考酮对肺癌根治术患者血流动力学及应激反应的影响。方法选择择期行肺癌根治术患者80例,随机分为两组各40例,O组静注盐酸羟考酮注射液0.3 mg/kg、丙泊酚2.0~2.5 mg/kg、顺苯磺酸阿曲库铵0.25 mg/kg行全麻诱导,S组静注枸橼酸舒芬太尼注射液0.3μg/kg、丙泊酚2.0~2.5 mg/kg、顺苯磺酸阿曲库铵0.25 mg/kg行全麻诱导,诱导后两组均插入双腔支气管导管。记录诱导前(T_0)、插管前即刻(T_1)、插管即刻(T_2)、插管后1 min(T_3)、插管后5 min(T_4)的平均动脉压(MAP)、心率(HR),测定T_0、T_2、T_3、T_4时点血浆肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(Cor)及血糖(Glu),记录诱导期间发生呛咳例数。结果与同组T_0时点比较,两组T_1时点MAP、HR降低,T_2、T_3时点MAP、HR升高(P均0.05);与S组比较,O组T_1时点MAP、HR降低,T_2、T_3时点MAP、HR升高(P均0.05)。与同组T_0时点比较,两组T_2和T_3时点E、NE、Cor、Glu水平升高(P均0.05);与S组比较,O组T_2和T_3时点E、NE、Cor、Glu水平降低(P均0.05)。O组发生呛咳反应0例,S组为21例(35%),两组比较,P0.05。结论静注羟考酮行全麻诱导可以更有效维持患者血流动力学平稳,降低应激反应发生率。
[Abstract]:Objective to observe the effect of intravenous administration of hydroxycodone on hemodynamics and stress response in patients with lung cancer after radical resection of lung cancer under general anesthesia. Methods 80 patients undergoing elective radical resection of lung cancer were selected. 40 patients in each group were randomly divided into two groups, 40 patients in each group received intravenous injection of hydroxycodone hydrochloride (0.3 mg / kg), propofol 2.0 (2.5 mg / kg), and atracurium cisbenzenesulfonate (0.25 mg/kg). Group S received intravenous injection of sufentanil citrate (0.3 渭 g / kg), propofol (2.02.5 mg / kg) and atracurium sulfonate (0.25 mg/kg). Ammonium 0.25 mg/kg was induced by general anesthesia. After induction, the two groups were inserted into double-lumen bronchial catheters.The mean arterial pressure MAPP and HRT were recorded before induction, immediately before induction, immediately before intubation, immediately after intubation, immediately after intubation, 1 minute after intubation, 1 minute after intubation, 5 min after intubation, and 5 min after intubation. Plasma epinephrine was measured at T0T2T3T4 and noradrenaline was measured. The incidence of cough during induction was recorded. The results were compared with those in the same group at T0 time point. MAPHR decreased at T1 time in both groups and MAPHR increased at T _ 2 / T _ T _ 3 in both groups, and MAPHR increased at T _ (1) and T _ (3) in O group as compared with that in S group. Compared with T _ (0) point in the same group, MAPHR increased in both groups. In both groups, the level of EneneCorCorn Glu increased at T _ 2 and T _ 3 in both groups (P 0.05), compared with that in group S, the levels of Glu in E _ Necao _ Corn _ Glu were decreased at T _ 2 and T _ 3 in group T _ 2 and T _ 3, respectively. There were 21 cases of cough reaction in group S and 21 cases in group S, which were compared with those in group S (P 0.05). Conclusion the induction of general anesthesia by intravenous injection of hydrocodone can be more effective than that of group S. Maintain hemodynamic stability effectively, Reduce the incidence of stress response.
【作者单位】：郑州大学附属肿瘤医院;
【基金】：河南省科技攻关计划项目(162102310337)
【分类号】：R614;R734.2

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