摘要
目的探究在大面积烧伤患者中使用异丙酚静脉麻醉对患者凝血功能及血小板聚集的影响。方法纳入笔者研究小组所在医院大面积烧伤患者60例,根据麻醉方式不同分为两组,观察组采用异丙酚静脉麻醉,对照组采用氯胺酮静脉麻醉。对比两组不同时间血小板[Ca^(2+)]i、血小板聚集率、凝血指数和凝固时间的变化。结果术中30min、120 min和停药60 min时观察组血小板聚集率及血小板[Ca^(2+)]i降低,且低于对照组;在上述时间段中对照组各指标明显升高。术中30 min至停药60 min时凝血指数低于对照组,凝固时间长于对照组;对照组术中120 min至停药60 min凝血指数较麻醉诱导前高,凝固时间在术中60 min至停药60 min较麻醉诱导前短(P均<0.05)。结论大面积烧伤患者应用异丙酚静脉麻醉能降低血小板[Ca^(2+)]i,抑制血小板聚集,缓解术中高凝状态。
Objective To explore the effect of propofol intravenous anesthesia on coagulation function and platelet aggregation in patients with extensive burns.Methods 60 cases of patients with extensive burns in the hospital of our research group were selected and divided into two groups(observation group and control group)according to different anesthesia methods.The observation group were given propofol intravenous anesthesia,while the control group were given ketamine intravenous anesthesia.And then,the changes of platelet[Ca 2+]i,platelet aggregation rate,coagulation index and coagulation time were compared between the two groups at different times.Results The platelet aggregation rate and platelet[Ca 2+]i decreased in the observation group at 30 min,120 min during operation and 60 min after withdrawal,and they were lower than those of the control group.The indexes of the control group increased obviously in the above-mentioned time periods.The coagulation index of the observation group was lower than that of the control group at 30 min during operation and 60 min after withdrawal,and coagulation time was longer than that of the control group.In the control group,the coagulation index between 120 min during operation and 60 min after withdrawal was higher than that before the anesthesia induction,and the coagulation time between 60 min during operation and 60 min after withdrawal was shorter than that before the anesthesia induction(all P<0.05.).Conclusion Intravenous anesthesia with propofol can reduce platelet[Ca 2+]i,inhibit platelet aggregation and relieve intraoperative hypercoagulation in patients with extensive burns.
作者
李祯
吴黎生
李慧
LI Zhen;WU Lisheng;LI Hui(Department of Anesthesiology,No.159 Hospital of PLA,Zhumadian 463000,China)
出处
《右江医学》
2018年第5期561-564,共4页
Chinese Youjiang Medical Journal
关键词
静脉麻醉
异丙酚
大面积烧伤
凝血功能
血小板聚集
游离钙
intravenous anesthesia
propofol
extensive burns
coagulation function
platelet aggregation
free calcium
作者简介
李祯,女,主治医师,研究方向:烧伤麻醉。E-mail:731170981@qq.com。
