摘要
目的 :观测安氟醚与七氟醚复合氧化亚氮吸入诱导及维持麻醉对心脏瓣膜手术病人血流动力学的影响。方法 :42例病人分两组 ,分别以安氟醚 氧化亚氮 (Ⅰ组 ,n =2 0 )或七氟醚 氧化亚氮 (Ⅱ组 ,n =2 2 )吸入诱导及维持麻醉。采用Swan Ganz导管技术监测血流动力学。结果 :诱导后两组MAP、CI、LVWI及LVSWI有所减低 (P <0 0 5 )。气管插管后 ,两组的CI、SI及LVSWI明显降低 (P <0 0 5 ) ,HR、RAP、PCWPPTRI和PORI等明显增高 (P <0 0 1)。锯胸骨后 ,两组的CI、SI、LVWI、LVSWI及RVSWI仍明显低于麻醉前 ,PORI和SVRI仍显著增高 (P <0 0 1)。CPB开始前 ,两组的SI、LVWI、LVSWI及RVSWI仍明显低于麻醉前 (P <0 0 5 )。两组间的血流动力学变化对比未见有统计学差异。结论 :安氟醚或七氟醚复合氧化亚氮吸入诱导 ,对心脏瓣膜手术病人血流动力学影响轻微。
Objective:To observe the hemodynamic effects of enfluraneor N 2O or sevoflurane N 2O inhalation for patients undergoing cardiac valve procedures.Method:42 patients were divided into two groups.Group Ⅰ was induced with enflurane N 2O,and group Ⅱ with sevoflurane N 2O inhalation.Hemodynamic monitoring was performed with Swan Ganz catheter technique.Results:The induction courses were rather smooth.During induction,no significant changes in HR,SI,MPAP,PTRI,PVRI or SVRI were observed,but MAP,CI,LVWI and LVSWI decreased significantly ( P< 0 01) in two groups.After sternotomy,the RAP,PTRI,PORI and SVRI of the two groups increased ( P< 0 01),and CI,SI,LVWI,LVSWI,RVWI and RVSWI further decreased ( P< 0 01),and MPAP,PCWP,PVRI still further increased ( P< 0 01).Immediately before CPB,MAP,LVSWI,RVWI,RVSWI and RVSW still tended to reduction( P< 0 05).Conclusion:Anesthesia induction with enflurane N 2O or sevoflurane N 2O inhalation has slight effect on the hemody namics in patients undergoing cardiac valvular surgery.Maintenance of anesthesia with enflurane N 2O or sevoflurane N 2O may not be ideal in depressing the adverse effects of stress on the hemodynamics during intubation.
出处
《临床麻醉学杂志》
CAS
CSCD
2000年第8期380-382,共3页
Journal of Clinical Anesthesiology
