相同七氟醚浓度下不同年龄和性别对BIS及血流动力学影响的临床观察

发布时间：2018-05-21 08:30

本文选题：七氟醚 + 年龄　；参考：《中南大学》2014年硕士论文

【摘要】：目的：探讨在相同七氟醚肺泡内有效浓度下,不同年龄组和不同性别患者的脑电双频谱指数(Bispectral index, BIS)的变化；同时观察在七氟醚麻醉诱导下,不同年龄组和不同性别患者的心率及平均动脉压的变化。方法：60例患者按年龄分成两大组,分别为年轻组(20-40y)老年组(60y)；同时将上述两大组患者按性别不同分为四组,分别为年轻男性组(Male young组)和年轻女性组(Female young组)；老年男性组(Male Old组)和老年女性组(Female Old组)。每组患者入室前均不使用术前用药,入手术室后常规建立静脉通道,除进行常规心电监测外,同时监测直接动脉压,BIS值以及吸入麻醉气体监护,记录其BIS,心率及平均动脉压的基础值；麻醉诱导使用8%七氟醚,氧流量为6L/min,当BIS值为50以下并维持1min后,根据患者的体重置入相应型号的喉罩,喉罩置入后将七氟醚浓度调整为2%,患者保持自主呼吸,并维持呼气末二氧化碳浓度为35-45mmHg,当气体监护仪显示肺泡内七氟醚浓度为2%时,并维持10min。记录第11min时候患者的BIS值,心率及平均动脉压,观察各组患者BIS值,以及血流动力学变化。结果：年轻组(Y组)的BIS下降幅度低于老年组(0组)的BIS下降幅度,P0.05。年轻组和老年组中,不同性别之间的BIS下降幅度差异没有统计学意义,P0.05。年轻组(Y组)的心率(heart rate, HR)变化值跟老年组(0组)的心率(HR)变化值的差异无统计学意义,P0.05。年轻组(Y组)的平均动脉压下降值低于老年组(0组)的平均动脉压(MAP)下降值,P0.05。在年轻组和老年组中,不同性别之间的心率(HR),平均动脉压(MAP)的变化程度差异没有统计学意义,P0.05。结论：1、在相同浓度的七氟醚作用下,老年组的患者BIS下降的值要大于年轻组患者BIS下降的值； 2、在相同浓度的七氟醚作用下,老年组患者的心率变化值跟年轻组患者的心率变化值相似； 3、在相同浓度的七氟醚作用下,老年组患者的平均动脉压(MAP)下降值要大于年轻组患者的MAP下降值； 4、在相同浓度的七氟醚作用下,相同年龄组的患者,不同性别之间的BIS,心率及平均动脉压的变化程度没有明显差异。
[Abstract]:Objective: to investigate the changes of bispectral index (BISs) in patients with different age groups and different genders under the same effective concentration of sevoflurane, and to observe the changes of bispectral index (BISs) induced by sevoflurane anesthesia. Changes of heart rate and mean arterial pressure in different age groups and different genders. Methods Sixty patients were divided into two groups according to their age: the young group (20-40 yr), the elderly group (60 yg), and the two groups were divided into four groups according to their sex. Young male group (Male young group), young female group (Female young group), aged male group (Male Old group) and elderly female group (Female Old group). Each group of patients did not use preoperative medication before entering the room. After entering the operating room, venous channels were established routinely. In addition to routine ECG monitoring, BIS values of direct arterial pressure and monitoring of inhaled anesthetic gases were monitored at the same time. The basal values of BIS, heart rate and mean arterial pressure were recorded, 8% sevoflurane was used to induce anesthesia, the oxygen flow rate was 6 L / min, and when the BIS value was below 50 and 1min was maintained, the laryngeal mask was placed according to the patient's weight. After laryngeal mask placement, the concentration of sevoflurane was adjusted to 2. The patient maintained spontaneous respiration and maintained end-expiratory carbon dioxide concentration of 35-45 mm Hg.When the gas monitor showed that the concentration of sevoflurane in the alveoli was 2 and maintained for 10 minutes. The BIS, heart rate and mean arterial pressure were recorded at the time of 11min. The BIS values and hemodynamic changes were observed. Results: the decrease of BIS in the young group was lower than that in the old group (P 0.05). There was no significant difference in the decrease of BIS between the young group and the elderly group (P 0.05). There was no significant difference in heart rate and heart rate between the young group and the old group (P 0.05). The decrease value of mean arterial pressure in young group (P < 0.05) was lower than that in group (0) (P < 0.05). There was no significant difference in the changes of heart rate HRV and mean arterial pressure (MAPP) between young group and elderly group (P 0.05). Conclusion under the same concentration of sevoflurane, the decrease of BIS in the elderly group was higher than that in the young group. 2. Under the same concentration of sevoflurane, the change of heart rate in the elderly group was similar to that in the young group. 3. Under the same concentration of sevoflurane, the decrease of mean arterial pressure (MAP) in the elderly group was higher than that in the young group. 4. Under the same concentration of sevoflurane, there was no significant difference in BIS, heart rate and mean arterial pressure between different genders in the same age group.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614

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