不同麻醉维持方法在高血压患者脑动脉瘤栓塞术中的比较

发布时间：2018-05-26 01:05

本文选题：全身麻醉 + 脑动脉瘤栓塞术　；参考：《广东医学》2015年14期

【摘要】：目的探讨不同麻醉维持方法在合并高血压患者行脑动脉瘤栓塞术中的麻醉效果。方法 45例合并高血压的脑动脉瘤栓塞术患者,分为静脉泵注丙泊酚+泵注瑞芬太尼组(A组)、吸入七氟烷+静脉泵注瑞芬太尼组(B组)和吸入七氟烷+静脉泵注丙泊酚+泵注瑞芬太尼组(C组),记录患者插管前(T0)、气管插管时(T1)、手术开始时(T2)、手术结束时(T3)及拔除气管导管时(T4)各时间点的有创动脉收缩压(SBP)、舒张压(DBP)、心率(HR)、脉搏血氧饱和度(Sp O2),术后拔管时间和患者清醒时间;观察并记录整个麻醉期给予血管活性药物的种类和次数。结果 3组患者在T0和T1时SBP、DBP、HR及Sp O2的差异无统计学意义;T2、T3、T4时两组患者SBP、DBP及HR的差异均有统计学意义(P0.05),Sp O2的差异无统计学意义(P0.05)。3组患者术中使用血管活性药物存在一定差异,其中A组显著高于B组,差异有统计学意义(P0.05)。结论 3种麻醉维持方法均可顺利完成手术,七氟烷复合瑞芬太尼维持麻醉使合并高血压的脑动脉瘤栓塞术患者血流动力学相对更平稳,使用其他血管活性药物更少。
[Abstract]:Objective to investigate the anesthetic effect of different anesthesia maintenance methods in cerebral aneurysm embolization in patients with hypertension. Methods 45 cases of cerebral aneurysm embolization with hypertension, The patients were divided into two groups: intravenous infusion of propofol pump and remifentanil group (group A), sevoflurane intravenous pump injection of remifentanil group (group B) and sevoflurane infusion pump of propofol pump injection of remifentanil group (group C). Patients were recorded before intubation. T0, T1 during tracheal intubation, T2 at the beginning of the operation, T3 at the end of the operation and T4 at the end of the extubation), SBP, DBP, HR, SPO 2, extubation time and waking time of the patients. Observe and record the types and times of vasoactive drugs given throughout the anesthesia period. Results there was no significant difference in SBPnDBPU HR and SPO _ 2 between the three groups at T _ 0 and T _ 1. There was no significant difference in SBPnDBP and HR between the two groups at T _ 2 T _ 3T _ 3 and T _ 4. There was no significant difference between the three groups in using vasoactive drugs during operation in P0.05.3 group. Group A was significantly higher than group B (P 0.05). Conclusion all the three methods of maintenance of anesthesia can successfully complete the operation. Sevoflurane combined with remifentanil maintenance anesthesia can make the hemodynamics of patients with hypertensive cerebral aneurysm embolization more stable and the use of other vasoactive drugs less.
【作者单位】：暨南大学第二临床医学院广东省深圳市人民医院麻醉科;
【基金】：广东省深圳市科技创新委员会基金课题(编号:JCY20140416122812031)
【分类号】：R614

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