依托咪酯联合丙泊酚在精神障碍共患高血压患者无抽搐电休克治疗的应用

发布时间：2018-08-06 21:48

【摘要】：目的:比较依托咪酯与丙泊酚联用或单用对精神障碍共患高血压患者无抽搐电休克(MECT)围术期治疗效果及不良反应。方法:90例入组患者随机分为:EP组(依托咪酯0.3 mg/kg联合丙泊酚1.0 mg/kg)、E组(依托咪酯0.7 mg/kg)和P组(丙泊酚2.0 mg/kg),依次静脉诱导后行电休克治疗。记录麻醉前、诱导后即刻、电击后即刻及电击后5 min血压、心率、末梢脉搏血氧饱和度,监测心电图、首次MECT治疗的抽搐能量抑制指数、运动发作时间、自主呼吸恢复及苏醒时间及麻醉不良反应的发生情况。结果:EP组和E组运动发作时间较P组长(P0.05),能量抑制指数较P组高(P0.05);EP组在诱导前后、电击前后血压心率维持平稳;E组在电击后血压较麻醉前明显升高(P0.05);P组诱导后即刻血压较麻醉前明显下降(P0.05)。EP组与E组注射痛发生率明显低于P组(P0.05),恶心、呕吐、呃逆、躁动等不良反应3组患者无明显差异。结论:精神障碍共患高血压病患者行MECT治疗以依托咪酯联合丙泊酚复合麻醉MECT治疗效果好,围术期心血管事件风险较低,且麻醉不良反应少,临床可考虑推广应用。
[Abstract]:Aim: to compare the efficacy and side effects of etomidate combined with propofol or propofol alone in the treatment of non-convulsive electroshock (MECT) patients with hypertension. Methods 90 patients were randomly divided into two groups: group E (etomidate 0.3 mg/kg plus propofol 1.0 mg/kg) and group P (propofol 2.0 mg/kg). Before anesthesia, immediately after induction, immediately after shock and 5 min after shock, blood pressure, heart rate, peripheral pulse oxygen saturation, electrocardiogram (ECG), energy inhibition index of convulsion, time of motor attack were recorded. The recovery and recovery time of spontaneous respiration and the occurrence of adverse reaction of anesthesia. Results the time of motor attack in group E and group E was longer than that in group P (P0.05), and the energy inhibition index in group E was higher than that in group P (P0.05) before and after induction. Before and after electric shock, the blood pressure in group E was significantly higher than that before anesthesia (P0.05). The incidence of injection pain in group EP and group E was significantly lower than that in group E (P0.05), nausea, vomiting, hiccup, nausea, vomiting, and hiccup, the incidence of injection pain in group E was significantly lower than that in group E (P0.05). There was no significant difference in adverse reactions such as restlessness among the three groups. Conclusion: MECT is effective in the treatment of MECT combined with propofol combined with MECT, the perioperative risk of cardiovascular events is lower, and the adverse reaction of anesthesia is less, so clinical application can be considered.
【作者单位】：广州市脑科医院(广州市惠爱医院)麻醉科;
【基金】：广州市医药卫生科技项目(编号:20151A010065)
【分类号】：R614

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