依托咪酯与丙泊酚对异位妊娠失血性休克患者全身麻醉诱导时循环系统以及麻醉深度影响的比较

发布时间：2018-11-09 07:16

【摘要】：目的比较依托咪酯与丙泊酚对异位妊娠失血性休克患者全身麻醉诱导时循环系统以及麻醉深度的影响。方法选取2013年5月至2015年4月于双流县第一人民医院进行治疗的80例异位妊娠失血性休克患者为研究对象,采用随机数字表编码法分为依托咪酯组和丙泊酚组,各40例。依托咪酯组给予咪唑安定+芬太尼+依托咪酯+维库溴胺诱导插管;丙泊酚组给予咪唑安定+芬太尼+丙泊酚+维库溴胺诱导插管。监测记录两组患者麻醉前(T_1)、诱导中(T_2)及维持后10 min(T_3)、30 min(T_4)、50 min(T_5)的心率、平均动脉压(MAP)、脑电双频指数(BIS)和脉搏血氧饱和度(Sp O_2)。结果两组T_2心率均较T1时下降,T_3、T_4、T_5时均回升[依托咪酯组:(91±8)次/min、(110±6)次/min、(111±9)次/min、(107±8)次/min比(108±9)次/min;丙泊酚组:(86±5)次/min、(105±7)次/min、(109±9)次/min、(102±6)次/min比(107±8)次/min],保持平稳,依托咪酯组各时间点心率均高于丙泊酚组(P0.05)。依托咪酯组T_2、T_3、T_4、T_5时MAP呈先上升后下降趋势,丙泊酚组呈下降趋势[依托咪酯组:(53±7)mmH g(1 mmHg=0.133 kP a)、(54±7)mmHg、(55±9)mmHg、(54±6)mmHg;丙泊酚组:(46±8)mmHg、(46±8)mmHg、(45±7)mmHg、(43±6)mmHg],依托咪酯组各时点MAP高于丙泊酚组(P0.05)。依托咪酯组和丙泊酚组所有患者SpO_2均为100%。依托咪酯组和丙泊酚组T_2、T_3、T_4、T_5时BIS较诱导前显著降低(P0.05),两组间、不同时间点、组间·不同时间点交互作用比较差异无统计学意义(P0.05)。结论依托咪酯用于异位妊娠失血性休克患者全身麻醉诱导时循环系统稳定性优于丙泊酚,且两种药物所致麻醉深度无明显差异。
[Abstract]:Objective to compare the effects of etomidate and propofol on circulatory system and anesthetic depth during induction of general anesthesia in patients with hemorrhagic shock of ectopic pregnancy. Methods from May 2013 to April 2015, 80 patients with ectopic pregnancy with hemorrhagic shock were selected and divided into etomidate group and propofol group (40 cases each). Etomidate group received midazolam fentanyl etomidate vecurbromine induction intubation; propofol group midazolam fentanyl propofol vecurbromine induction intubation. The heart rate, mean arterial pressure (MAP),) and mean arterial pressure (MAP),) before anesthesia, 10 min after induction and 10 min after maintenance, 30 min (T _ 4), 50 min (T _ S _ 5) were monitored and recorded in both groups. Bispectral index (BIS) and pulse blood oxygen saturation (Sp O _ 2). Results the heart rate of T _ 2 in both groups was lower than that in T _ 1, and T _ 3 / T _ 4 / T _ 5 increased at 5 h. [etomidate group: (91 卤8) / min, (110 卤6) / min, (111 卤9) / min, (107 卤8) / min = (108 卤9) / min; In propofol group: (86 卤5) times / min, (105 卤7) times / min, (109 卤9) times / min, (102 卤6) times / min was (107 卤8) times / min], the dim sum rate of etomidate group was higher than that of propofol group (P0.05). In the etomidate group, the MAP increased first and then decreased at T _ 2T _ T _ 3 / T _ 4 _ T _ 5, and then decreased in propofol group [(53 卤7) mmH g (_ 1 mmHg=0.133 kP a), (_ 5 卤7) mmHg, (55 卤9) mmHg, (54 卤6) mmHg;] in the etomidate group [(53 卤7) mmH g (1 mmHg=0.133 kP a), (卤7) mmHg, (55 卤9) mmHg, (54 卤6) mmHg;]. In propofol group (46 卤8) mmHg, (, 46 卤8) mmHg, (, 45 卤7) mmHg, (, 43 卤6 mmHg), MAP in etomidate group was higher than that in propofol group (P0.05). The SpO_2 of etomidate group and propofol group was 100. The BIS of etomidate group and propofol group were significantly lower than that before induction (P0.05). There was no significant difference in interaction between groups at different time points (P0.05). Conclusion the stability of circulatory system in patients with ectopic pregnancy hemorrhagic shock induced by etomidate is superior to that of propofol, and there is no significant difference in the depth of anesthesia between the two drugs.
【作者单位】：双流县第一人民医院麻醉科;
【分类号】：R614.2

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