【摘要】：目的探討不同肝硬化程度患者經(jīng)靶控輸注(TCI)丙泊酚進(jìn)行麻醉誘導(dǎo)時(shí)效應(yīng)室濃度水平。方法選取2014年5月—2016年7月在成都市公共衛(wèi)生臨床醫(yī)療中心接受腹部外科手術(shù)治療的65例患者作為研究對(duì)象,根據(jù)患者肝功能child-pugh分級(jí)標(biāo)準(zhǔn)進(jìn)行分級(jí),以20例肝功能正常非肝硬化患者作為對(duì)照組,20例肝硬化患者且肝功能為A級(jí)的患者作為A組,25例肝硬化患者且肝功能為B級(jí)或C級(jí)患者作為B組,患者均進(jìn)行TCI丙泊酚進(jìn)行麻醉誘導(dǎo),比較3組患者在術(shù)前血漿清蛋白、膽紅素、尿素氮水平,比較3組患者意識(shí)消失[鎮(zhèn)靜警覺(jué)評(píng)分(改良OAA/S評(píng)分≤1分)]和腦電雙頻譜指數(shù)(BIS)50時(shí)的丙泊酚靶效應(yīng)室、濃度和丙泊酚的用量。結(jié)果術(shù)前A、B兩組患者中血漿清蛋白水平低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)前A、B兩組患者間血漿清蛋白水平比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后A組患者的血漿清蛋白水平低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)前和術(shù)后B組患者的膽紅素水平高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)前、術(shù)后A組膽紅素水平與對(duì)照組比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);三組患者在術(shù)前尿素氮水平比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。在患者意識(shí)消失時(shí),A組患者的丙泊酚效應(yīng)室濃度、丙泊酚靶濃度和用量均高于對(duì)照組,B組患者的各項(xiàng)水平均低于對(duì)照組和A組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);在BIS值50時(shí),A、B兩組患者的丙泊酚效應(yīng)室濃度、丙泊酚靶濃度和用量均低于對(duì)照組,B組的各值低于A組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論隨著患者肝硬化程度的加重,在麻醉誘導(dǎo)中所需丙泊酚的用量越低。
[Abstract]:Objective to investigate the effect chamber concentration during anesthesia induction by target controlled infusion (TCI) of propofol in patients with different degrees of cirrhosis. Methods Sixty-five patients who received abdominal surgery from May 2014 to July 2016 in Chengdu Public Health Clinical Medical Center were selected as the study subjects. The patients were graded according to the child-pugh grading criteria of liver function. Twenty patients with normal liver function and non-cirrhosis as control group, 20 patients with liver cirrhosis with grade A liver function as group A, 25 patients with liver cirrhosis and patients with grade B or grade C liver function as group B, All patients were induced by TCI propofol. The plasma albumin, bilirubin and urea nitrogen levels were compared between the three groups. The consciousness loss [sedation and alertness score (improved OAA / S score 鈮，

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