摘要
目的探讨不同肝硬化程度患者经靶控输注(TCI)丙泊酚进行麻醉诱导时效应室浓度水平。方法选取2014年5月—2016年7月在成都市公共卫生临床医疗中心接受腹部外科手术治疗的65例患者作为研究对象,根据患者肝功能child-pugh分级标准进行分级,以20例肝功能正常非肝硬化患者作为对照组,20例肝硬化患者且肝功能为A级的患者作为A组,25例肝硬化患者且肝功能为B级或C级患者作为B组,患者均进行TCI丙泊酚进行麻醉诱导,比较3组患者在术前血浆清蛋白、胆红素、尿素氮水平,比较3组患者意识消失[镇静警觉评分(改良OAA/S评分≤1分)]和脑电双频谱指数(BIS)50时的丙泊酚靶效应室、浓度和丙泊酚的用量。结果术前A、B两组患者中血浆清蛋白水平低于对照组,差异有统计学意义(P<0.05);术前A、B两组患者间血浆清蛋白水平比较,差异无统计学意义(P>0.05);术后A组患者的血浆清蛋白水平低于对照组,差异有统计学意义(P<0.05);术前和术后B组患者的胆红素水平高于对照组,差异有统计学意义(P<0.05);术前、术后A组胆红素水平与对照组比较,差异无统计学意义(P>0.05);三组患者在术前尿素氮水平比较,差异无统计学意义(P>0.05)。在患者意识消失时,A组患者的丙泊酚效应室浓度、丙泊酚靶浓度和用量均高于对照组,B组患者的各项水平均低于对照组和A组,差异有统计学意义(P<0.05);在BIS值50时,A、B两组患者的丙泊酚效应室浓度、丙泊酚靶浓度和用量均低于对照组,B组的各值低于A组,差异有统计学意义(P<0.05)。结论随着患者肝硬化程度的加重,在麻醉诱导中所需丙泊酚的用量越低。
Objective To investigate the effects of target-controlled infusion（ TCI） propofol on the induction of anesthesia in patients with different degrees of liver cirrhosis. Methods Fifty-six patients who underwent abdominal surgery from May 2014 to July 2016 at the Chengdu Public Health Clinical Medical Center were selected as the subjects. According to the criteria of child-pugh grading,the normal liver function patients with non-cirrhosis as a control group,20 patients with liver cirrhosis and liver function as a group of patients as A group,25 patients with liver cirrhosis and liver function for the B or C patients as B group,patients were TCI propof the levels of plasma albumin,bilirubin,and urea nitrogen were compared between the three groups of patients,and the sensory scores of the three groups were compared [the sedation alert score（ improved OAA/S score ≤1） ]and the bispectral spectrum Index（ BIS） 50,the propofol target chamber,the concentration and the amount of propofol. Results The levels of plasma albumin in group A and B were significantly lower than those in control group（ P 〈0. 05）. There was no significant difference in plasma albumin level between preoperative A and B groups（ P 〉 0. 05）. The levels of serum albumin in group A were lower than those in control group（ P 〈 0. 05）. The levels of bilirubin in group B were higher than those in control group（ P 〈 0. 05）. There was no significant difference in the levels of bilirubin in group A and control group（ P 〉 0. 05）. There was no significant difference in the levels of blood urea nitrogen（ P 〉 0. 05）. When the consciousness of the patients disappeared,the propofol concentration,propofol target concentration and dosage of group A were higher than those of the control group,the level of group B was lower than that of control group and group A,the difference was statistically（ P 〈 0. 05）. At the BIS value of 50,the propofol concentration,propofol target concentration and dosage of group A and B were
出处
《中国全科医学》
CAS
北大核心
2017年第A02期135-137,共3页
Chinese General Practice
关键词
肝硬化
丙泊酚
靶控输注
麻醉
Liver cirrhosis
Propofol
Target controlled infusion
Anesthesia
