不同剂量羟乙基淀粉电解质注射液预输注对胃切除术患者全麻诱导期血流动力学的影响

发布时间：2018-04-02 02:25

本文选题：羟乙基淀粉　切入点：胃切除术　出处：《临床麻醉学杂志》2015年06期

【摘要】：目的探讨不同剂量6%羟乙基淀粉130/0.4电解质注射液预输注对胃切除术患者全麻诱导期血流动力学的影响。方法择期行胃切除术患者90例,ASAⅠ或Ⅱ级,年龄40~50岁,根据全麻诱导前30min输注6%羟乙基淀粉130/0.4电解质注射液的剂量随机分为低剂量组(L组,5ml/kg)、中剂量组(M组,10ml/kg)和高剂量组(H组,15ml/kg)。以丙泊酚2mg/kg、罗库溴铵0.9mg/kg、舒芬太尼0.5μg/kg麻醉诱导。以FloTrac/Vigileo方法测定并记录输注前(T1)、诱导前(T2)、气管插管前(T3)时的HR、MAP、心指数(CI)、每搏量(SV)、每搏变异度(SVV)、外周血管阻力(SVR)、CVP。结果与T1时比较,T2、T3时三组患者MAP、CI、SV、CVP均明显升高,HR明显减慢,SVV、SVR明显降低(P0.05)。与L组比较,T2、T3时M组和H组HR明显减慢,MAP、SV、CVP明显升高,SVV和SVR明显降低,且H组MAP和CVP明显高于M组,SVR明显低于M组(P0.05)。结论全醉诱导前输注6%羟乙基淀粉130/0.4电解质注射液10ml/kg可有效预防胃切除术患者全麻诱导期低血压的发生,维持相对稳定的血流动力学。
[Abstract]:Objective to investigate the effect of different doses of 6% hydroxyethyl starch 130 / 0.4 electrolyte injection on hemodynamics of patients undergoing general anesthesia induction. According to the dose of 6% hydroxyethyl starch 130 / 0.4 electrolyte injection infused with 30min before induction of general anesthesia, it was randomly divided into low dose group (L group), middle dose group (10 ml / kg) and high dose group H group (15 ml / kg). Propofol 2 mg / kg, rocuronium 0. 9 mg / kg, sufentanil 0.5 渭 g/kg were used to induce anaesthesia of propofol 2 mg / kg, rocuronium 0. 9 mg / kg, sufentanil 0.5 渭 g/kg. FloTrac/Vigileo method was used to measure and record the HRMAPs, cardiac index, cardiac volume, variability and peripheral vascular resistance of the three groups during T2T3 and T2T3. Results compared with T 1, T2T3 and T2T3, the CVP of the three groups were significantly higher than that of the T 1 and T 2 T 3 groups, and that of the three groups were significantly higher than those of the T 2T3 group (P < 0. 05), and the cardiac index was higher than that of the control group (P < 0. 05), and the cardiac index was higher than that of the control group (P < 0. 05). The results showed that there was a significant increase in HR in all the three groups. Compared with L group, the HR of M group and H group were significantly slower than that of L group, and the levels of SVV and SVR in group M and H were significantly lower than those in group L. MAP and CVP in group H were significantly higher than those in group M (P 0.05). Conclusion Infusion of 6% hydroxyethyl starch 1300.4% electrolyte 10ml/kg before total intoxication can effectively prevent hypotension in patients undergoing general anesthesia. Maintain relatively stable hemodynamics.
【作者单位】：潍坊医学院麻醉学系;潍坊市人民医院麻醉科;
【分类号】：R614.2

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