發(fā)布時(shí)間：2018-03-27 17:47

  本文選題：羥考酮　切入點(diǎn)：舒芬太尼　出處：《山東醫(yī)藥》2017年23期

【摘要】：目的觀察全麻誘導(dǎo)中靜注羥考酮對(duì)肺癌根治術(shù)患者血流動(dòng)力學(xué)及應(yīng)激反應(yīng)的影響。方法選擇擇期行肺癌根治術(shù)患者80例,隨機(jī)分為兩組各40例,O組靜注鹽酸羥考酮注射液0.3 mg/kg、丙泊酚2.0~2.5 mg/kg、順苯磺酸阿曲庫銨0.25 mg/kg行全麻誘導(dǎo),S組靜注枸櫞酸舒芬太尼注射液0.3μg/kg、丙泊酚2.0~2.5 mg/kg、順苯磺酸阿曲庫銨0.25 mg/kg行全麻誘導(dǎo),誘導(dǎo)后兩組均插入雙腔支氣管導(dǎo)管。記錄誘導(dǎo)前(T_0)、插管前即刻(T_1)、插管即刻(T_2)、插管后1 min(T_3)、插管后5 min(T_4)的平均動(dòng)脈壓(MAP)、心率(HR),測(cè)定T_0、T_2、T_3、T_4時(shí)點(diǎn)血漿腎上腺素(E)、去甲腎上腺素(NE)、皮質(zhì)醇(Cor)及血糖(Glu),記錄誘導(dǎo)期間發(fā)生嗆咳例數(shù)。結(jié)果與同組T_0時(shí)點(diǎn)比較,兩組T_1時(shí)點(diǎn)MAP、HR降低,T_2、T_3時(shí)點(diǎn)MAP、HR升高(P均0.05);與S組比較,O組T_1時(shí)點(diǎn)MAP、HR降低,T_2、T_3時(shí)點(diǎn)MAP、HR升高(P均0.05)。與同組T_0時(shí)點(diǎn)比較,兩組T_2和T_3時(shí)點(diǎn)E、NE、Cor、Glu水平升高(P均0.05);與S組比較,O組T_2和T_3時(shí)點(diǎn)E、NE、Cor、Glu水平降低(P均0.05)。O組發(fā)生嗆咳反應(yīng)0例,S組為21例(35%),兩組比較,P0.05。結(jié)論靜注羥考酮行全麻誘導(dǎo)可以更有效維持患者血流動(dòng)力學(xué)平穩(wěn),降低應(yīng)激反應(yīng)發(fā)生率。
[Abstract]:Objective to observe the effect of intravenous administration of hydroxycodone on hemodynamics and stress response in patients with lung cancer after radical resection of lung cancer under general anesthesia. Methods 80 patients undergoing elective radical resection of lung cancer were selected. 40 patients in each group were randomly divided into two groups, 40 patients in each group received intravenous injection of hydroxycodone hydrochloride (0.3 mg / kg), propofol 2.0 (2.5 mg / kg), and atracurium cisbenzenesulfonate (0.25 mg/kg). Group S received intravenous injection of sufentanil citrate (0.3 渭 g / kg), propofol (2.02.5 mg / kg) and atracurium sulfonate (0.25 mg/kg). Ammonium 0.25 mg/kg was induced by general anesthesia. After induction, the two groups were inserted into double-lumen bronchial catheters.The mean arterial pressure MAPP and HRT were recorded before induction, immediately before induction, immediately before intubation, immediately after intubation, immediately after intubation, 1 minute after intubation, 1 minute after intubation, 5 min after intubation, and 5 min after intubation. Plasma epinephrine was measured at T0T2T3T4 and noradrenaline was measured. The incidence of cough during induction was recorded. The results were compared with those in the same group at T0 time point. MAPHR decreased at T1 time in both groups and MAPHR increased at T _ 2 / T _ T _ 3 in both groups, and MAPHR increased at T _ (1) and T _ (3) in O group as compared with that in S group. Compared with T _ (0) point in the same group, MAPHR increased in both groups. In both groups, the level of EneneCorCorn Glu increased at T _ 2 and T _ 3 in both groups (P 0.05), compared with that in group S, the levels of Glu in E _ Necao _ Corn _ Glu were decreased at T _ 2 and T _ 3 in group T _ 2 and T _ 3, respectively. There were 21 cases of cough reaction in group S and 21 cases in group S, which were compared with those in group S (P 0.05). Conclusion the induction of general anesthesia by intravenous injection of hydrocodone can be more effective than that of group S. Maintain hemodynamic stability effectively, Reduce the incidence of stress response.
【作者單位】： 鄭州大學(xué)附屬腫瘤醫(yī)院;
【基金】：河南省科技攻關(guān)計(jì)劃項(xiàng)目(162102310337)
【分類號(hào)】：R614;R734.2

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