摘要
目的:研究分析在老年冠心病患者全麻诱导期运用七氟醚和丙泊酚对心率变异性的作用。方法:选取2015年10月—2016年10月在本院接受上腹部手术治疗的老年冠心病患者50例作为研究对象。采用随机数字表法分为观察组和对照组,各25例。对照组运用靶控输注丙泊酚进行麻醉,观察组使用七氟醚进行麻醉。分析两组麻醉前以及麻醉后5,10,15,20分钟时的心率(HR)、心率变异性(HRV)、舒张压(DBP)以及收缩压(SBP)的变化。结果:两组麻醉诱导后5,10分钟阶段DBP、SBP、HR均低于麻醉前,差异有统计学意义(P <0.05);麻醉后5,10,15分钟阶段观察组SBP,DBP高于对照组,HR低于对照组,差异有统计学意义(P <0.05);麻醉后20分钟,两组DBP,SBP比较差异无统计学意义(P> 0.05),观察组HR低于对照组,差异有统计学意义(P <0.05);诱导后5,10,15,20 min,两组低频(LF)显著低于麻醉前,差异有统计学意义(P <0.05);诱导后10,15,20 min,对照组高频(HF)低于麻醉前,且低于观察组,LF/HF高于麻醉前,且高于观察组,差异有统计学意义(P <0.05)。结论:老年冠心病患者行上腹部手术治疗时,采用吸入七氟醚的方式麻醉比运用靶控输注丙泊酚的麻醉方式对患者自主神经功能影响要轻,诱导过程患者表现平稳,具有较高的临床使用价值。
Objective:To investigate and analyze the effect of sevoflurane and propofol used in elderly patients with coronary heart diseases during anesthesia induction period on heart rate variability.Methods:50 patients with coronary heart diseases who underwent upper abdominal surgery in our hospital from October 2015 to October 2016 were selected as subjects investigated.The patients were randomly divided into an observation group and a control group,25 cases each.The patients in the control group were anesthetized with target-controlled infusion of propofol,and the patients in the observation group were anesthetized with sevoflurane.The changes in heart rate(HR),heart rate variability(HRV),diastolic blood pressure(DBP)and systolic blood pressure(SBP)before anesthesia and 5,10,15 and 20 minutes after anesthesia in the two groups were analyzed.Results:The DBP,SBP and HR at 5 and 10 minutes after anesthesia induction were lower than those before anesthesia in the two groups,and the differences were statistically significant(P<0.05).The SBP and DBP in the observation group were higher than those in the control group,at 5,10 and 15 minutes after anesthesia,and the HR in the observation group was lower than that in the control group,with statistically significant differences(P<0.05).There were no statistically significant differences in DBP and SBP at 20 minutes after anesthesia between the two groups(P>0.05),and the HR in the observation group was lower than that in the control group,with statistically significant difference(P<0.05).The low frequency(LF)at 5,10,15 and 20 minutes after induction was significantly lower than that before anesthesia in the two groups,with statistically significant differences(P<0.05).The high frequency(LF)at 10,15 and 20 minutes after induction was significantly lower than that before anesthesia in the control group,which was lower than that in the observation group,with statistically significant differences(P<0.05).Conclusion:Sevoflurane inhalation anesthesia has less effect on autonomic nervous function in elderly patients with coronary heart diseases undergoing upper abdominal surgery than target-controlled propofol infusion and has high clinical use value,and during the induction process,the conditions of the patients were stable.
作者
华敬
Hua Jing(Department of Anesthesiology,the Second People’s Hospital of Pingdingshan,Pingdingshan,Henan 467000,China)
出处
《中国合理用药探索》
CAS
2019年第3期122-125,130,共5页
Chinese Journal of Rational Drug Use
关键词
老年冠心病
麻醉诱导期
七氟醚
丙泊酚
心率变异性
Elderly Coronary Heart Disease
Anesthesia Induction Period
Sevoflurane
Propofol
Heart Rate Variability
作者简介
华敬,男,副主任医师。研究方向:麻醉,疼痛。E-mail:838490391@qq.com
