【摘要】 目的探讨依托咪酯乳剂复合丙泊酚在腹部手术全身麻醉中的麻醉效果,以期为临床麻醉方案的选择提供依据。方法选择2017年1月至2018年10月期间在云浮市人民医院行腹部手术的93例患者为研究对象,根据随机数表法分为A组、B组、C组,每组31例,其中A组麻醉诱导应用丙泊酚,B组应用依托咪酯乳剂,C组则联合应用依托咪酯乳剂及丙泊酚。比较三组患者麻醉诱导前(T0)、气管插管前1 min (T1)、插管时(T2)以及插管后15 min (T3)不同时间点的收缩压(SBP)、心率(HR)及血糖浓度的变化。结果与T0比较,A组患者T1、T3时HR、SBP明显降低,且A组患者T1、T3时HR、SBP明显低于B组、C组,差异均有统计学意义(P<0.05);B组、C组患者T1、T3时HR无明显变化(P>0.05),仅在T2时SBP升高明显,差异有统计学意义(P<0.05);与T0比较,A组患者T1、T2、T3时血糖浓度无明显变化(P>0.05),而B组、C组患者T1、T2、T3时血糖浓度明显明显高于T0时,且明显高于同时期的A组,差异均有统计学意义(P<0.05);C组患者T1、T2、T3时血糖浓度明显低于B组,差异具有统计学意义(P<0.05)。结论在腹部手术全身麻醉时,依托咪酯复合丙泊酚诱导优于单纯丙泊酚或依托咪酯,其对血流动力学影响小,应激反应轻。更多还原

【Abstract】 Objective To investigate the anesthetic effect of etomidate emulsion combined with propofol for general anesthesia in abdominal surgery, and to provide evidence for the selection of clinical anesthesia regime.Methods Ninety-three patients undergoing abdominal surgery in Yunfu People’s Hospital from January 2017 to October 2018 were divided into group A, group B, and group C according to the random number table, with 31 patients in each group. The patients were treated with propofol during anesthesia induction in group A, etomidate emulsion in group B, and etomidate emulsion and propofol in group C. The changes of systolic blood pressure(SBP), heart rate(HR), and blood glucose were compared in three groups at different time points, including before anesthesia induction(T0), 1 min before tracheal intubation(T1), intubation(T2),15 minutes after intubation(T3). Results Compared with T0, HR and SBP in group A decreased significantly at T1 and T3, and was lower than those in group B and group C(P<0.05). HR in group B and C did not change significantly at T1 and T3(P>0.05), but SBP increased significantly at T2(P<0.05). Compared with T0, blood glucose concentration in group A did not change significantly at T1, T2, and T3(P>0.05). The blood glucose concentration at T1, T2, and T3 in group B and group C was significantly higher than that at T0, and also significantly higher than that in group A at the same time(P<0.05), and that in group C at T1, T2, and T3 was significantly lower than that in group B(P<0.05). Conclusion The induction of etomidate combined with propofol is superior to propofol or etomidate alone in general anesthesia for abdominal surgery, and has little effect on hemodynamics, with mild stress reaction.更多还原