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41卷第5期
帕金森病患者术中血流动力学变化的临床观察修改后
刘志永,丁翠青,姚长青,杜永君,王忠义
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DOI:
作者:
刘志永,丁翠青,姚长青,杜永君,王忠义
LIU Zhi-yong,DING Cui-qing, YAO Chang-qing, DU Yong-jun, WANG Zhong-yi,
作者单位:
河北省衡水市哈励逊国际和平医院
Harrison International Peace Hospital, Hebei Medical University,
关键词:
帕金森病;全身麻醉;血流动力学;苏醒
Parkinson's disease; General anesthesia; Hemodynamics; Recovery
摘要:
目的 观察帕金森病对全身麻醉血流动力学的影响 方法 选择择期行下肢手术的帕金森病患者22例和非帕金森病患者24例,两组均使用咪达唑仑、芬太尼、顺阿曲库铵、丙泊酚行快顺序诱导,术中使用瑞芬太尼和丙泊酚维持麻醉,记录术前MAP和HR,诱导期及术中低血压、高血压发生次数和血管活性药物用量。术毕停止麻醉药物输注,并统计用量,观察并记录拔管时间、拔管后Stewart评分和拔管10min后的MAP、HR。结果 诱导期,PD组最低MAP低于NP组(P<0.05),低MAP发生次数、去氧肾上腺素用量均高于NP组(均P<0.05);手术期,瑞芬太尼和丙泊酚用量均低于NP组(均P<0.05)术;PD组拔管时间长于NP组,Steward评分低于NP组术(均P<0.05)。结论 帕金森病可影响全身麻醉患者血流动力学稳定性,在麻醉诱导期更为显著。
Objective To investigate the influence of Parkinson's disease on the hemodynamics of patients under general anesthesia. Methods Twenty-two cases of Parkinson's sufferers (PD group) and twenty-four cases of non-Parkinson's sufferers (NP group) who underwent selective lower extremity surgery were enrolled in the present study. All subjects received rapid sequence induction (RSI) with midazolam, fentanyl, cis-atracurium, and propofol. Intraoperative anesthesia was maintained with remifentanil and propofol. The data including preoperative mean arterial pressure (MAP) and heart rate (HR), frequency of hypotension and hypertension in the induction period and intraoperative period, and dosage of vasoactive agent were respectively collected. The anesthetic agent was withdrawn at the end of the surgery, when the cumulative amount was documented. The extubation time, post-extubation Stewart score, and MAP and HR at 10 min after extubation were respectively collected. Results In the induction period, the minimum MAP in PD group was lower than that in NP group (both p<0.05); the frequency of low MAP and dosage of phenylephrine in PD group were respectively higher than those in NP group (both p<0.05). In the intraoperative period, the dosages of remifentanil and propofol in PD group were respectively lower than those in NP group; the extubation time in PD group was longer than that in NP group (both p<0.05); the Steward score in PD group was lower than that in NP group (both p<0.05). Conclusion Parkinson's disease can influence the stability of hemodynamics in patients under general anesthesia, which is more significant in the induction period of anesthesia.
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