| 吴 勇,陶广华,梁春姝,何文学,边 疆,盛 博.丙泊酚复合芬太尼静脉复合全麻在老年主动脉夹层介入手术中的麻醉效果研究[J].,2019,19(17):3379-3383 |
| 丙泊酚复合芬太尼静脉复合全麻在老年主动脉夹层介入手术中的麻醉效果研究 |
| Study on Anesthesia Effect of Propofol Combined with Fentanyl Intravenous Anesthesia in Elderly Patients Undergoing Interventional Aortic Dissection |
| 投稿时间：2018-12-28 修订日期：2019-01-23 |
| DOI：10.13241/j.cnki.pmb.2019.17.038 |
| 中文关键词: 丙泊酚 芬太尼 老年 主动脉夹层 麻醉 肺功能 循环功能 |
| 英文关键词: Propofol Fentanyl Elderly Aortic dissection Anesthesia Pulmonary function Circulatory function |
| 基金项目:四川省卫生计生委科研基金项目（16PJ171） |
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| 中文摘要: |
| 摘要 目的：探讨老年主动脉夹层介入手术采用丙泊酚复合芬太尼静脉复合全麻对患者麻醉效果的影响。方法：选取2015年6月到2018年3月四川省攀枝花市中心医院麻醉科接诊的老年胸、腹主动脉夹层行介入手术治疗的患者76例作为研究对象，采用随机数字表法将患者分为观察组（38例）及对照组（38例），观察组采用丙泊酚复合芬太尼静脉复合全麻，对照组采用丙泊酚静脉复合全麻，观察并比较两组患者循环功能指标[血压（DBP、SBP）、心率(HR）、平均动脉压（MAP）]、肺功能指标[呼吸频率（R）、呼气末二氧化碳（PETCO2）、血氧饱和度（SpO2）、气道压力（PAW）]及麻醉效果[脑电双频指数(BIS)值、苏醒时间（术后自主呼吸恢复时间、睁眼时间、定向力恢复时间）、拔管时间的组间差异。结果：观察组术后苏醒时间（自主呼吸恢复时间、睁眼时间、定向力恢复时间）及拔管时间低于对照组（P＜0.05）。观察组R在T1~T5时间点均低于对照组（P＜0.05），在T1时间点，观察组PETCO2低于对照组，PAW高于对照组（P＜0.05），观察组SpO2在T3、T4高于对照组（P＜0.05）；观察组HR、SBP、DBP、MAP在T1~T3时间点均高于对照组（P＜0.01）。观察组患者的HR、MAP在不同时间点间比较无统计学意义（P＞0.05）。结论：采用丙泊酚复合芬太尼静脉复合全麻对于老年主动脉夹层介入手术患者，具有降低患者呼吸及循环功能影响的效果，具有更优的麻醉效果。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of propofol combined with fentanyl intravenous anesthesia on anesthesia in elderly patients with undergoing interventional aortic dissection. Methods: From June 2015 to March 2018, 76 elderly patients with abdominal aortic dissection treated by interventional surgery were selected from Department of Anesthesiology, Panzhihua Central Hospital of Sichuan Province. Patients were randomly divided into observation group (n=38) and control group (n=38). The observation group was treated with propofol combined with fentanyl combined with general anesthesia, and the control group with propofol combined with general anesthesia. The difference of circulatory function[blood pressure (DBP, SBP), heart rate (HR), mean arterial pressure (MAP)], Lung function indexes [respiratory frequency(R), end-expiratory carbon dioxide (PETCO2), blood oxygen saturation (SpO2), airway pressure(PAW)] and anesthetic effect [bispectral index(BIS), anesthetic recovery time(Spontaneous respiratory recovery, Open your eyes, Directional force recovery）and extubation time were observed and compared. Results: The recovery time(Spontaneous respiratory recovery,Open your eyes, Directional force recovery) and extubation time of the observation group was lower than that of the control group (P<0.05), the R of the observation group was lower than that of the control group at the T1~T5 time point(P<0.05). At T1 time point, The PETCO2 of the observation group was lower than that of the control group, and the PAW was higher than that of the control group(P<0.05), the SpO2 of the observation group was higher than that of the control group at T3 and T4(P<0.05). The HR, SBP, DBP, MAP of the observation group was higher than that of the control group at T1~T3 time point(P<0.05), and there was no significant difference in HR and MAP between the observation group at different time points(P>0.05). Conclusion: Propofal combined with fentanyl combined with general anesthesia can reduce respiratory and circulatory function of elderly patients with interventional surgery aortic dissection and has better anaesthesia effect. |
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