艾司洛尔复合异丙酚对行胆囊切除术老年高血压患者气管插管应激反应的影响

发布时间：2018-08-04 17:31

【摘要】：目的:观察艾司洛尔复合异丙酚对行胆囊切除术老年高血压患者气管插管应激反应的影响。方法:36例拟行胆囊切除术的老年高血压患者随机均分为对照组(D0组)、艾司洛尔0.5 mg/kg组(D1组)、艾司洛尔1 mg/kg组(D2组)。各组患者均以异丙酚1.5 mg/kg为静脉麻醉诱导,D0组患者静脉注射0.9%氯化钠注射液10 ml;D1组患者静脉注射盐酸艾司洛尔注射液0.5 mg/kg;D2组患者静脉注射盐酸艾司洛尔注射液1 mg/kg。观察各组患者插管前及插管后1、3、5 min时的收缩压(SBP)、舒张压(DBP)、心率(HR)及血浆儿茶酚胺水平[去甲肾上腺素(NE)、肾上腺素(E)],并记录不良反应发生情况。结果:与插管前比较,D0组患者插管后1、3、5 min时SBP、DBP、HR均明显升高;D1组患者插管后1 min时SBP、DBP、HR均显著低于D0组,3、5 min时SBP、DBP、HR均显著低于同组插管前及D0组;D2组患者插管后1、3、5 min时SBP、DBP、HR均显著低于同组插管前及D0、D1组,差异均有统计学意义(P0.05)。D1组患者插管后1 min时NE水平显著低于同组插管前,3、5 min时显著高于同组插管前,而1、3、5 min时E水平均显著高于同组插管前;D2组患者插管后1、3、5 min时NE、E水平均显著低于同组插管前,且1、3 min时E水平显著低于D1组,差异均有统计学意义(P0.05)。两组患者均未见明显不良反应发生。结论:艾司洛尔1 mg/kg复合异丙酚用于老年高血压患者胆囊切除术麻醉,可有效缓解气管插管时的心血管应激反应,且安全性较好。
[Abstract]:Aim: to observe the effect of esmolol combined with propofol on stress response of tracheal intubation in elderly hypertensive patients undergoing cholecystectomy. Methods Thirty-six elderly hypertensive patients undergoing cholecystectomy were randomly divided into control group (D0), esmolol 0.5 mg/kg group (D1 group) and esmolol 1 mg/kg group (D2 group). All patients were induced by propofol 1.5 mg/kg by intravenous anesthesia. The patients in group D _ 0 received 0.9% sodium chloride injection 10 ml / d _ 1 by intravenous injection of esmolol hydrochloride 0.5 mg 路kg ~ (-1) 路kg ~ (2) and group D _ (2) by intravenous injection of esmolol hydrochloride injection (1 mg / kg 路kg ~ (-1). Systolic blood pressure (SBP), diastolic pressure (DBP), heart rate (HR) and plasma catecholamine (noradrenaline (NE), adrenaline (E) were measured before intubation and at 1: 3 and 5 min after intubation, and adverse reactions were recorded. Results: compared with before intubation, SBPnDBPHR in group D 0 were significantly higher than those in group D 0 at 1 min after intubation, and at 1 min after intubation in group D 1 were significantly lower than those in group D 0 at 5 min after intubation, and those in group D 0 were significantly lower than those in group D 0 before intubation and 1 day and 5 min after intubation in group D 0. The HR of SBP and DBP were significantly lower than those of the same group before intubation and D0 D 1 group. The difference was statistically significant (P0.05). The NE level in D1 group was significantly lower at 1 min after intubation than that in the same group at 35 min before intubation, which was significantly higher than that before intubation in the same group. The E level of D 2 group was significantly higher than that of D 2 group at 5 min after intubation (P 0.05). The E level of D 2 group was significantly lower than that of D 1 group at 1 ~ 3 min after intubation (P 0.05), and the E level of D 2 group was significantly lower than that of D 1 group at 1 ~ 3 min after intubation (P 0.05). No significant adverse reactions occurred in both groups. Conclusion: esmolol 1 mg/kg combined with propofol for cholecystectomy anesthesia in elderly patients with hypertension can effectively relieve cardiovascular stress response during tracheal intubation and is safe.
【作者单位】：湖北谷城县人民医院;
【分类号】：R614.2

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