瑞芬太尼或芬太尼复合丙泊酚全麻对老年手术患者心功能及血流动力学指标的影响对比

doi:10.3969/j.issn.1006-6233.2020.07.034

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摘要 目的:探讨瑞芬太尼或芬太尼复合丙泊酚全麻对老年手术患者心功能及血流动力学指标的影响。方法:以2017年12月至2019年6月我院收治的220例老年手术患者为研究对象,并随机分为观察组(110例)和对照组(110例)。对照组采用芬太尼复合丙泊酚进行麻醉,观察组采用瑞芬太尼复合丙泊酚进行麻醉,比较两组患者在麻醉诱导前(T0)、气管插管前(T1)、气管插管后即刻(T2)、手术切皮时(T3)及术毕10min(T4)心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉血压(MAP)、左心射血分数(LVEF%)、心脏每搏量(SV)、心输出量(CO)、心指数(CI)变化情况,记录两组患者手术相关指标及并发症发生情况。结果:T0及T4期,两组患者HR、SBP、DBP、MAP、LVEF%、SV、CO及CI比较无统计学差异(P>0.05),T1~T3期,观察组各指标水平均显著高于对照组(P<0.05)。观察组拔管时间、睁眼时间、自主呼吸时间、定向力恢复时间以及不良反应发生率均显著低于对照组(P<0.05)。结论:选择瑞芬太尼复合丙泊酚对老年手术患者进行全麻,可稳定患者心功能及血流动力学,改善患者术后清醒时间、安全性高,值得推广运用。

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	陈元利
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关键词 ：瑞芬太尼, 芬太尼, 丙泊酚, 心功能, 血流动力学

Abstract：Objective: To investigate the effects of remifentanil or fentanyl combined with propofol general anesthesia on cardiac function and hemodynamic parameters in elderly patients. Methods: A total of 220 elderly patients admitted to our hospital from December 2017 to June 2019 were randomly divided into observation group (110 cases) and control group (110 cases). The changes of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (map), left ventricular ejection fraction (LVEF), cardiac stroke volume (SV), cardiac output (CO), cardiac index (CI) were compared before anesthesia induction (t0), before tracheal intubation (T1), immediately after tracheal intubation (T2), at the time of skin incision (T3) and 10 minutes after operation (T4) The operation related indexes and complications of the two groups were recorded. Results: There was no significant difference in HR, SBP, DBP, map, LVEF%, SV, CO and CI between the two groups in t0 and T4 period (P > 0.05). The time of extubation, time of opening eyes, time of spontaneous respiration, time of recovery of orientation force and incidence of adverse reactions in the observation group were significantly lower than those in the control group (P < 0.05). Conclusion: Remifentanil combined with propofol for general anesthesia can stabilize the patient's heart function and hemodynamics, improve the awake time and safety of patients, and it is worthy of popularization.

Key words： Remifentanil Propofol Cardiac function Hemodynamics

基金资助:重庆市医学科研项目,(编号:2015ZBXM088)

引用本文:

陈元利, 谢健, 陈菲. 瑞芬太尼或芬太尼复合丙泊酚全麻对老年手术患者心功能及血流动力学指标的影响对比[J]. 河北医学, 2020, 26(7): 1200-1204.
CHEN Yuanli, XIE Jian, CHEN Fei. Comparison on Effects of Remifentanil or Fentanyl Combined with Propofol General Anesthesia on Cardiac Function and Hemodynamic Parameters in Elderly Patients Undergoing Surgery. HeBei Med, 2020, 26(7): 1200-1204.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2020.07.034 或 http://www.hbyxzzs.cn/CN/Y2020/V26/I7/1200

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