摘要
目的探讨超声瞬时波强(WI)技术监测参附注射液对老年高血压患者全麻诱导期血流动力学的影响。方法选择择期行腹部手术的全麻气管插管老年高血压患者40例,随机分为参附组和对照组,每组20例。分别于注药前(T1)、滴注参附注射液/葡萄糖注射液后1 min(T2)、全麻诱导期(T3)、插管前(T4)、插管后1 min(T5)、插管后10 min(T6)测量心率、无创血压以及超声WI各参数。超声WI参数包括:瞬时加速度波强(W1)、收缩中期的反向波(NA)、收缩晚期的瞬时减速度波强(W2)、射血前期时间(R-W1)、射血时间(W1-W2)。结果对照组T3时收缩压、舒张压、心率、W1、W2、NA、W1-W2较T1时明显降低,RW1明显升高,差异有统计学意义(P <0. 05); T5时收缩压、舒张压、心率、W1、W2、NA、W1-W2较T1时明显升高,差异有统计学意义(P <0. 05)。参附组T3时收缩压、舒张压、心率、W1、W2、NA、W1-W2高于B组T3时点,R-W1低于对照组T3时点,差异有统计学意义(P <0. 05);参附组T5时收缩压、舒张压、心率、W1、W2、NA、W1-W2低于对照组T3时点,R-W1高于对照组T5时点,差异有统计学意义(P <0. 05)。结论WI技术能较好评估参附注射液对老年高血压患者全麻诱导期心血管功能的变化,预注参附注射液可以明显减缓老年高血压患者全麻诱导期心血管的波动,起到稳定作用。
Objective To investigate the effect of Shenfu Injection on hemodynamics by ultrasonic wave intensity（ WI） technique during induction of general anesthesia in elderly patients with hypertension. Methods Forty elderly patients with hypertension undergoing general anesthesia for elected abdominal surgeries were randomly divided into Shenfu group（ Group A） and control group（ Group B）. Heart rate and non-invasive blood pressures were measured before injection（ T1）,1 minute after injection of Shenfu injection/Glucose Injection（ T2）,during general anesthesia induction（ T3）,pre-intubation（ T4）,1 minute after intubation（ T5） and 10 minutes after intubation（ T6）. The ultrasonic WI parameters were obtained,including instantaneous acceleration wave intensity（ W1）,mid-systolic reverse wave（ NA）,instantaneous late systolic deceleration wave intensity（ W2）,pre-injection time（ R-W1） and ejection time（ W1-W2）. Results At T3,systolic blood pressure,diastolic blood pressure,heart rate,W1,W2,NA and W1-W2 in Group B were significantly lower than at T1,while R-W1 was significantly increased（ P〈0. 05）. At T5,systolic and diastolic blood pressures,heart rate,W1,W2,NA and W1-W2 in Group B were significantly increased compared to T1（ P〈0. 05）. At T3,systolic blood pressure,diastolic blood pressure,heart rate,W1,W2,NA and W1-W2 in Group A were significantly higher than those in Group B（ P〈0. 05）,while R-W1 was significantly lower（ P〈0. 05）. At T5,systolic blood pressure,diastolic blood pressure,heart rate,W1,W2,NA and W1-W2 in Group A were significantly lower than those in Group B（ P〈0. 05）,while R-W1 was significantly lower（ P〈0. 05）. Conclusion WI technique can better evaluate Shenfu Injection on cardiovascular function during induction of general anesthesia for elderly patients with hypertension. Pre-treatment of Shenfu Injection can significantly reduce cardiovascular events in elder patients with hypertension during induction of general anesthe
作者
林岚
余革
龙诗樱
邱少东
麦幸欢
LIN Lan;YUGe;LONG Si-ying;QIU Shao-dong;MAI Xing-huan(The Second Affiliated Hospital of Guangzhou Medical University,1 Ultrasonography department,2Department of anesthesiology（Guangzhou,510260)
出处
《广东医学》
CAS
2018年第19期2895-2897,2902,共4页
Guangdong Medical Journal
基金
广州市中医药和中西医结合科技项目(编号:20152A011025)
