摘要
目的探讨氯胺酮、丙泊酚和依托咪酯对2型糖尿病患者行全身麻醉的血流动力学影响。方法选取60例行全身麻醉手术的2型糖尿病患者，并选择同期行全身麻醉手术的非糖尿病患者60例，将120例患者随机分成丙泊酚组、氯胺酮组和依托咪酯组，每组40例，2型糖尿病与非糖尿病患者各占一半，分别用丙泊酚、氯胺酮、依托咪酯麻醉诱导，观察各组的收缩压、心率、每搏量和心排血量变化情况。结果行氯胺酮麻醉中，2型糖尿病患者的收缩压（82±8）mmHg（1 mmHg=0.133 kPa）、心率（60±10）次/min和心排血量（3.1±1.2）L/min明显低于非糖尿病患者的[（92±6）mmHg、（73±7）次/min及（3.9±1.1）L/min]（P〈0.05）。行依托咪酯麻醉中，2型糖尿病患者的收缩压（109±6）mmHg明显高于非糖尿病患者的（97±5）mmHg（P〈0.05），而心率（55±9）次/min和心排血量（3.3±1.1）L/min则明显低于非糖尿病患者的（68±7）次/min和（4.0±0.9）L/min（P〈0.05）。行丙泊酚麻醉中，2型糖尿病患者的收缩压（116±7）mmHg明显高于非糖尿病患者的（104±5）mmHg（P〈0.05）。在2型糖尿病患者中，行氯胺酮麻醉的收缩压（82±8）mmHg明显低于丙泊酚组的（116±7）mmHg（P〈0.05），行丙泊酚麻醉的心率（77±7）次/min和心排血量（5.0±0.9）L/min明显高于氯胺酮的（60±10）次/min和（3.1±1.2）L/min和依托咪酯组的（55±9）次/min和（3.3±1.1）L/min（P〈0.05）。结论不同的麻醉药物对2型糖尿病患者的血流动力学会产生不一样的影响，应针对患者的具体情况选择不同的麻醉药物。
ObjectiveTo explore the cardiovascular surgery stress responses of propofol, ketamine and etomidate in patients with type 2 diabetes. MethodsSxity patients with type 2 diabetes and sixty patients with nondiabetic diseases receiving general anesthesia were selected and all the patients were randomly divided into three groups： propofol group （40 patients）, ketamine group （40 patients） and etomidate group （40 patients）. Changes in systolic blood pressure, heart rate, stroke volume and cardiac output were observed after aneasthetic induction with propofol, ketamine and etomidate. Results The systolic blood pressure, heart rate and cardiac output in patients with type 2 diabetes after aneasthetic induction with ketamine were significantly lower than those in patients with nondiabetic diseases [（82±8） mmHg, （60±10）times/min and （3.1±1.2） L/min vs （92±6） mmHg, （73±7）times/min and （3.9±1.1）L/min] （P〈0.05）. The systolic blood pressure in patients with type 2 diabetes after aneasthetic induction with etomidate was significantly higher than that in patients with nondiabetic diseases[ （109±6） mmHg vs （97±5） mmHg）]（P〈0.05）, while heart rate and cardiac output were significantly lower than those in patients with nondiabetic diseases [（55±9）times/min and （3.3±1.1）L/min versus （68±7）times/min and （4.0±0.9）L/min] （P〈0.05）. The systolic blood pressure in patients with type 2 diabetes after aneasthetic induction with propofol was significantly higher than that in patients with nondiabetic diseases [（116±7） mmHg vs （104±5） mmHg] （P〈0.05）. The systolic blood pressure after aneasthetic induction with ketamine was significantly lower than that induced with propofol [（82±8） mmHg vs （116±7） mmHg）（P〈0.05）, while the heart rate and cardiac output after aneasthetic induction with propofol were significantly higher than those induced with etomidate and ketamine[ （77±7）times/min and （5.0±0.9�
出处
《中国医药》
2014年第7期1009-1011,共3页
China Medicine
