摘要
目的:观察高血压手术患者异丙酚复合瑞芬太尼控制性降压的安全性。方法:择期行胃癌、直肠癌根治术高血压患者60例,随机分为两组,降压组(Ⅰ组)30例,对照组(Ⅱ组)30例。Ⅱ组不施行控制性降压,Ⅰ组于打开腹膜后开始降压,瑞芬太尼初始速度为每分钟0.25μg/kg,每隔2 min增加每分钟0.1μg/kg,直到降至术前血压的75%。分别记录诱导前(T0)、降压开始即刻(T1)、20 min(T2)、40 min(T3)、停止降压10 min(T4)的HR、MAP,并于各时间点抽桡动脉和颈内静脉血标本,即刻行血气分析,计算动脉血氧浓度(CaO2)、颈内静脉血氧浓度(CjvO2)、脑氧摄取率(CERO2)及脑动脉-静脉氧浓度差(Da-jvO2)。结果:与T0比较,T2、T3、T4时Ⅰ组CjvO2升高,Da-jvO2及CERO2降低不明显(P>0.05);Ⅱ组以上指标差异无统计学意义(P>0.05)。与Ⅱ组比较,Ⅰ组T2、T3、T4时CjvO2升高,Da-jvO2及CERO2降低无统计学意义(P>0.05)。结论:异丙酚复合瑞芬太尼用于高血压手术患者控制性降压安全、有效。
Objective：To observe the surgery in patients with hypertension propofol combined with remifentanil-induced hypotension security.Methods：selective gastric cancer,rectal cancer radical mastectomy 60 cases of hypertensive patients were randomly divided into two groups step-down group（I group） 30 cases,the control group（Ⅱ group） 30 cases.Ⅱ not to apply the controlled hypotension group,I group in the beginning of open retroperitoneal buck,remifentanil initial rate of 0.25 μg/（kg·min）,every 2 min increased 0.1 μg/（kg·min）, until the pre-operative blood pressure dropped to 75%.Record blood pressure,respectively,to start immediately,20 min,40 min,stop buck 10 min of HR,MAP,and was pumped at different time points the radial artery and internal jugular venous blood samples,blood gas analysis line instantly calculate the arterial oxygen concentration（CaO2） carotid within the venous oxygen concentration（CjvO2）,cerebral oxygen uptake rate（CERO2） and cerebral arterial-venous oxygen concentration difference（Da-jvO2）.Results：T0 compared with,T2、 T3、 T4 increased CjvO2 when the group Ⅰ,Da-jvO2 and lower CERO2 not obvious（P 0.05）;Ⅱ above target group there was no significant difference（P 0.05）.And Ⅱ group,I group T2、 T3、 T4、 when CjvO2 increased、 Da-jvO2 and lower CERO2 no significant（P 0.05）.Conclusion：The results of propofol combined with remifentanil for controlled hypotension in patients with hyper-tension surgery safe and effective.
出处
《内蒙古医学杂志》
2010年第2期157-159,共3页
Inner Mongolia Medical Journal
关键词
异丙酚
瑞芬太尼
降压
高血压
Propofol Remifentanil Hypotensive Hypertension
