全麻胃切除术中琥珀酰明胶注射液预输注剂量分析

发布时间：2018-02-03 01:33

本文关键词： 琥珀酰明胶预输注剂量全麻胃切除手术血流动力学　出处：《山东医药》2017年04期 　论文类型：期刊论文

【摘要】：目的探讨全麻胃切除术中琥珀酰明胶注射液预输注的适宜剂量。方法选取行全麻下胃切除手术的晚期胃癌患者93例,随机分为低、中、高剂量组,每组31例,分别于全麻诱导前30 min预输注4.0%琥珀酰明胶注射液5、10、15 m L/kg,比较各组注射前、注射后10 min和1 h时血细胞比容(HCT)、血清离子、血浆组胺、外周静脉血各项指标及空腹血糖水平变化,观察各组全麻期间不良反应发生情况。结果中剂量组注射10 min和1 h时HCT明显高于低、高剂量组,血浆组胺明显低于低、高剂量组,血清Cl-、Na+明显低于高剂量组,血清K+、Ca2+水平明显高于高剂量组;组间比较P均0.05。注射10 min和1 h时,中、高剂量组HR、每搏变异度(SVV)、外周血管阻力(SVR)均低于同时间点低剂量组,每搏量(SV)、中心静脉压(CVP)、平均动脉压(MAP)均高于同时间点低剂量组;高剂量组MAP、CVP高于同时间点中剂量组,SVR低于同时间点中剂量组;组间比较P均0.05。低剂量组全麻期间不良反应发生率为12.90%,中剂量组为9.68%,高剂量组为35.48%;高剂量组不良反应发生率高于低、中剂量组(P均0.05)。结论用于全麻胃切除术中琥珀酰明胶预输注的适宜剂量为10 m L/kg。
[Abstract]:Objective to study the appropriate dose of succinyl gelatin injection in general anesthesia gastrectomy. Methods 93 patients with advanced gastric cancer undergoing general anesthesia were randomly divided into low, middle and high dose groups. 31 patients in each group were preinfused with 4.0% succinyl gelatin injection at 30 min before induction of general anesthesia. The changes of HCT, serum ion, plasma histamine, peripheral venous blood indexes and fasting blood glucose were observed at 10 min and 1 h after injection. Results the HCT of the middle dose group was significantly higher than that of the low dose group after 10 min and 1 h injection. The plasma histamine level in the high dose group was significantly lower than that in the low and high dose group. The level of serum K ~ (2 +) Ca ~ (2 +) was significantly higher than that of high dose group. At 10 min and 1 h after 10 min and 1 h injection, HR-SVV, SVVV per stroke variability and peripheral vascular resistance were lower in the middle and high dose groups than in the low-dose group at the same time point. The mean arterial pressure (MAPP), central venous pressure (CVP) and SVV volume were higher than those in the low dose group at the same time point. The SVR of high dose group was higher than that of middle dose group at the same time point, and the SVR of high dose group was lower than that of middle dose group at the same time point. The incidence of adverse reactions during general anesthesia was 12.90 in the low dose group, 9.68 in the middle dose group and 35.48 in the high dose group. The incidence of adverse reactions in the high dose group was higher than that in the low dose group, and in the middle dose group it was 0.050.Conclusion the appropriate dose for preinfusion of succinyl gelatin in general anesthesia gastrectomy is 10 mL / kg.
【作者单位】：海南医学院附属医院;
【基金】：海南省自然科学基金资助项目(813189)
【分类号】：R614.2
【正文快照】： 胃切除手术时采用的全麻药物可造成患者心脑血管、肺等功能抑制,导致血液灌注降低[2]。容量治疗是麻醉过程中不可缺少的部分,可减轻麻醉诱导期间血流动力学的急剧改变,维持机体血流动力学稳定[3],降低因内环境剧烈变化引起的心血管事件发生率。琥珀酰明胶是第一代等张性血浆代

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