摘要
目的探讨不同剂量6%羟乙基淀粉130/0.4电解质注射液预输注对胃切除术患者全麻诱导期血流动力学的影响。方法择期行胃切除术患者90例,ASAⅠ或Ⅱ级,年龄40～50岁,根据全麻诱导前30min输注6%羟乙基淀粉130/0.4电解质注射液的剂量随机分为低剂量组（L组,5ml/kg）、中剂量组（M组,10ml/kg）和高剂量组（H组,15ml/kg）。以丙泊酚2mg/kg、罗库溴铵0.9mg/kg、舒芬太尼0.5μg/kg麻醉诱导。以FloTrac/Vigileo方法测定并记录输注前（T1）、诱导前（T2）、气管插管前（T3）时的HR、MAP、心指数（CI）、每搏量（SV）、每搏变异度（SVV）、外周血管阻力（SVR）、CVP。结果与T1时比较,T2、T3时三组患者MAP、CI、SV、CVP均明显升高,HR明显减慢,SVV、SVR明显降低（P〈0.05）。与L组比较,T2、T3时M组和H组HR明显减慢,MAP、SV、CVP明显升高,SVV和SVR明显降低,且H组MAP和CVP明显高于M组,SVR明显低于M组（P〈0.05）。结论全醉诱导前输注6%羟乙基淀粉130/0.4电解质注射液10ml/kg可有效预防胃切除术患者全麻诱导期低血压的发生,维持相对稳定的血流动力学。
Objective To investigate the effects of pre-infusion different doses 6% hydroxyethyl starch 130/0.4electrolyte injection before the induction of anesthesia on hemodynamics during general anesthesia induction in gastrectomy patients.Methods Ninety patients of both sexes,ASA ⅠorⅡ adults aged 40-50 years,scheduled for elective gastrectomy,were randomly divided into 3groups according to the dosage of 6% hydroxyethyl starch 130/0.4electrolyte injection infused before general anesthesia induction（n=30each）：the low dose group（group L,5 ml/kg）,the middle dose group（group M,10 ml/kg）,the high dose group（group H,15 ml/kg）.Anesthesia was induced with propofol 2mg/kg,rocuronium 0.9mg/kg and sufentanil 0.5μg/kg.HR,MAP,CI,SV,SVV,SVR,CVP were measured at the time before infusion（T1）,before induction（T2）,after induction（T3）by FloTrac/Vigileo.Results Compared with T1,MAP,CI,SV and CVP were increased significantly at T2 and T3,while HR,SVV and SVR were decreased in all groups（P〈0.05）.Compared with group L,HR,SVV and SVR in groups M and H were decreased at T2 and T3,while MAP,SV and CVP were increased（P〈0.05）.Compared with group M,MAP and CVP in group H were higher and SVR were lower at T2 and T3（P〈0.05）.Conclusion Infusion of 6% hydroxyethyl starch 130/0.4electrolyte injection 10ml/kg before induction of anesthesia can effectively decrease occurrence of low blood pressure in patients underwent elective gastrectomy during general anesthesia induction,and maintain a relatively stable hemodynamics.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2015年第6期559-561,共3页
Journal of Clinical Anesthesiology
关键词
羟乙基淀粉
胃切除术
全麻
血流动力学
Hydroxyethyl starch
Gastrectomy
General anesthesia
Hemodynamics
