摘要
目的分析讨论血浆白蛋白浓度对淋巴外科胸导管成形术全麻苏醒时间及苏醒期丙泊酚效应室浓度的影响。方法选择2018-2019年我院因胸导管梗阻、狭窄的患者择期全麻下行胸导管成形术手术患者90例,根据患者术前白蛋白的含量随机均分为A、B、C 3组(n=30)。术中3组患者给予相同的麻醉处理,记录3组患者诱导时患者失去意识的时间(T1)、各组停药时BIS值、停药到BIS≥80恢复时间(T2)、自主呼吸恢复时间(T3)、苏醒时间(T4)、拔管时间(T5)。记录两组患者的丙泊酚意识消失Ce、停药到BIS≥80丙泊酚Ce、丙泊酚苏醒Ce。血流动力学事件发生例数和发生概率。结果一般资料比较差异无统计学意义(P> 0.05);T2、T3、T4、T5等对比差异无统计学意义(P> 0.05);3组患者在停药时BIS值对比差异有统计学意义,组间比较A、B两组与C组比较差异有统计学意义(P <0.05),A、B两组组间对比差异无统计学意义(P> 0.05)。3组患者T1对比,组间两两比较差异均有统计学意义(P> 0.05);3组患者血流动力学发生概率对比差异有统计学意义(P <0.05)。结论胸导管梗阻、狭窄的患者行淋巴外科胸导管成形术时,不同程度血浆白蛋白浓度的患者在丙泊酚靶控输注全麻中基本呈现相似的变化趋势,但低蛋白血症患者麻醉诱导时意识消失快,更易出现血流动力学事件。
Objective This study aimed to analyze the effects of plasma albumin concentration on the recovery time and the concentration of propofol effector compartment during general anesthesia in Thoracic catheteroplasty.Methods 90 cases of patients with thoracic duct obstruction and stenosis under elective general anesthesia in our hospital between 2018 and 2019 were selected.According to the preoperative albumin content of the patients,they were randomly divided into 3 groups(n=30).Patients in the three groups were given the same anesthesia treatment during the operation,and the time of loss of consciousness at the induction of patients in the three groups.The BIS value at the time of drug withdrawal in each group,the recovery time from drug withdrawal to BIS≥80,the recovery time of spontaneous breathing,the recovery time,and the time of extubation were recorded.Ce loss of propofol consciousness,Ce withdrawal to BIS) 80 and Ce recovery of propofol were recorded in both groups.Number of cases and probability of occurrence of hemodynamic events.Results there was no significant difference in general data(P> 0.05).There was no statistical difference between T2,T3,T4 and T5(P> 0.05).The BIS values of patients in the three groups were statistically significant when they were stopped,and the differences between group A and group B and group C were statistically significant(P <0.05),while the differences between group A and group B were not statistically significant(P> 0.05).T1 was compared among the three groups,and the pairwise difference was statistically significant(P> 0.05).There were statistically significant differences in the occurrence probability of hemodynamics among group A,B and C(P <0.05).Conclusion In patients with thoracic duct obstruction and stenosis undergoing lymphatic surgical thoracic catheteroplasty,different levels of plasma albumin concentration basically showed a similar change trend during the target controlled infusion of propofol under general anesthesia.However,patients with hypoproteinemia experienced rapid loss of consciousness during anesthesia induction and were more likelv to have hemodvnamic events.
作者
宋明雪
盛崴宣
姜静雯
关雷
SONG Mingxue;SHENG Weixuan;JIANG Jingwen;GUAN Lei(The Ninth School of Clinical Medicine,Peking University,Beijing 100038,China)
出处
《实用医学杂志》
CAS
北大核心
2020年第15期2129-2132,共4页
The Journal of Practical Medicine
基金
北京市科委首都特色研究项目(编号:Z161100000516158)。
关键词
血浆白蛋白浓度
胸导管成形术
丙泊酚
靶控输注
效应室浓度
plasma albumin concentration
thoracic catheteroplasty
propofol
TCI
effect chamber concentration
