【摘要】 目的:探讨全身麻醉手术（以下简称"全麻"）患者应用丙泊酚联合依托咪酯诱导对气管插管期间血流动力学的影响。方法:选择2013年1月—2014年12月就诊且需全麻手术的129例患者作为研究对象,采用随机数字表法将患者分为3组,丙泊酚组（P组）、依托咪酯组（E组）、丙泊酚联合依托咪酯组（C组）,每组患者43例,记录诱导前（T_<sub>0）、置喉镜前（T_<sub>1）、插管即刻（T_<sub>2）、插管后1 min（T_<sub>3）、插管后3 min（T_<sub>4）、插管后5 min（T_<sub>5）时患者的收缩压（systolic blood pressure,SBP）、舒张压（diastolic blood pressure,DBP）、平均动脉压（mean arterial pressure,MAP）、心率（heart rate,HR）;并记录患者在诱导期不良反应的发生情况。结果:与T₀比较,E组患者T_l、T₅时MAP、DBP、SBP均降低,P组患者T₁、T₄、T₅时的MAP、SBP与DBP均降低,E组与P组患者T_l时SBP、DBP均显著下降,差异有统计学意义（P<0.05）;与T₁比较,E组患者T₂时的HR显著上升,T₃时的SBP、DBP、HR、MAP显著上升,差异均有统计学意义（P<0.05）;与E组比较,C组患者T₂时HR显著下降,T₂时DBP显著上升,差异有统计学意义（P<0.05）。诱导期间E组和P组患者不良反应发生率为27.91%（12/43）、25.58%（11/43）,均高于C组的4.65%（2/43）,差异有统计学意义（P<0.05）。结论:与丙泊酚单药相比,丙泊酚联合依托咪酯可使全麻患者插管期间的血流动力学更好地保持稳定。更多还原

【Abstract】 OBJECT_IVE: T_o probe into the effects of propofol combined with etomidate on hemodynamics of patients with abdominal operation under general anesthesia（ hereinafter referred to as "general anesthesia "） during intubation.MET_HODS: 129 patients receiving general anesthesia and admitted into the hospital from Jan. 2013 to Dec. 2014 were selected as the research objects,according to the random number table,the patients were divided into propofol group（ P group）,etomidate group（ E group）,propofol combined with etomidate group（ C group）,with 43 patients in each group.And SBP,DBP,MAP,HR were recorded before induction（ T₀）,before setting laryngoscope（ T₁）,intubation（ T₂）,intubation after 1 min（ T₃）,3 min（ T₄）,5 min（ T₅）; the occurrence of adverse reactions during induction were also recorded. RESULT_S: Compared with T₀,the MAP,SBP,DBP of E group patients at T_l,T₅ decreased,the MAP,SBP,DBP of P group at T₁、T₄、T₅also decreased,and SBP and DBP of P group and E group at T₁ both had the significant decrease,the differences were statistically significant（ P < 0. 05）. Compared with T₁,HR of E group at T₂ were significantly increased,and SBP、DBP、HR、MAP at T₃ were also significantly increased,with significant difference（ P < 0. 05）.Compared with E group,HR of C group at T₂ decreased a lot,and DBP at T₂ increased a lot,with statistically significant difference（ P < 0. 05）. T_he incidence of adverse reactions during induction of E group [27. 91%（ 12 /43） ] and P group[25. 58%（ 11 /43） ]were significantly higher than that of C group [4. 65%（ 2 /43） ]with statistically significant difference（ P <0. 05）. CONCLUSIONS: Compared with single propofol,propofol combined with etomidate can keep up a steady of hemodynamics of patients with general anesthesia during intubation.更多还原