不同程度肝硬化患者丙泊酚麻醉诱导时效应室浓度的观察

发布时间：2018-07-17 20:04

【摘要】：目的探讨不同肝硬化程度患者经靶控输注(TCI)丙泊酚进行麻醉诱导时效应室浓度水平。方法选取2014年5月—2016年7月在成都市公共卫生临床医疗中心接受腹部外科手术治疗的65例患者作为研究对象,根据患者肝功能child-pugh分级标准进行分级,以20例肝功能正常非肝硬化患者作为对照组,20例肝硬化患者且肝功能为A级的患者作为A组,25例肝硬化患者且肝功能为B级或C级患者作为B组,患者均进行TCI丙泊酚进行麻醉诱导,比较3组患者在术前血浆清蛋白、胆红素、尿素氮水平,比较3组患者意识消失[镇静警觉评分(改良OAA/S评分≤1分)]和脑电双频谱指数(BIS)50时的丙泊酚靶效应室、浓度和丙泊酚的用量。结果术前A、B两组患者中血浆清蛋白水平低于对照组,差异有统计学意义(P0.05);术前A、B两组患者间血浆清蛋白水平比较,差异无统计学意义(P0.05);术后A组患者的血浆清蛋白水平低于对照组,差异有统计学意义(P0.05);术前和术后B组患者的胆红素水平高于对照组,差异有统计学意义(P0.05);术前、术后A组胆红素水平与对照组比较,差异无统计学意义(P0.05);三组患者在术前尿素氮水平比较,差异无统计学意义(P0.05)。在患者意识消失时,A组患者的丙泊酚效应室浓度、丙泊酚靶浓度和用量均高于对照组,B组患者的各项水平均低于对照组和A组,差异有统计学意义(P0.05);在BIS值50时,A、B两组患者的丙泊酚效应室浓度、丙泊酚靶浓度和用量均低于对照组,B组的各值低于A组,差异有统计学意义(P0.05)。结论随着患者肝硬化程度的加重,在麻醉诱导中所需丙泊酚的用量越低。
[Abstract]:Objective to investigate the effect chamber concentration during anesthesia induction by target controlled infusion (TCI) of propofol in patients with different degrees of cirrhosis. Methods Sixty-five patients who received abdominal surgery from May 2014 to July 2016 in Chengdu Public Health Clinical Medical Center were selected as the study subjects. The patients were graded according to the child-pugh grading criteria of liver function. Twenty patients with normal liver function and non-cirrhosis as control group, 20 patients with liver cirrhosis with grade A liver function as group A, 25 patients with liver cirrhosis and patients with grade B or grade C liver function as group B, All patients were induced by TCI propofol. The plasma albumin, bilirubin and urea nitrogen levels were compared between the three groups. The consciousness loss [sedation and alertness score (improved OAA / S score 鈮，

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