七氟醚麻醉在心脏手术患者的心肌保护作用研究

Research on Myocardial Preservation of Sevoflurane Anesthesia in Cardiac Surgery

目的:通过观察对比采用七氟醚和全凭静脉麻醉两种不同方式应用于心脏手术患者的情况,分析吸入七氟醚麻醉对患者心肌的保护作用。方法:将我院本次纳入观察的168例患者中83例采用全凭静脉麻醉手段,其余患者施予七氟醚麻醉,分析不同麻醉手段后患者的心肌和术后机体恢复状况。结果:观察组体外循环、麻醉、手术时间分别为(70.02±19.23)、(48.31±15.39)、(134.49±18.19)min,明显优于对照组(P<0.05);观察组以29.41%复跳率明显优于对照组85.95%的复跳率(P<0.05);观察组患者多巴胺和硝普钠总量、以及尿量和住院时间分别为(21.1±7.5)mg、(14.6±5.3)mg、(1211±313)mL、(8.6±5.1)d,明显优于对照组(P<0.05)。结论:七氟醚作为一种吸入麻醉药的七氟醚,对施行心脏手术的患者心肌功能的维护明显优于全凭静脉麻醉方式,且对患者手术后机体的恢复效果较为理想,在临床手术麻醉时可采纳该方式。

Objective：To observe and compare the two different methods, sevoflurane anesthesia and total intravenous anesthesia （TIVA）, used in cardiac surgery, and to analyze the myocardial preservation of sevoflurane inhalation anesthesia on patients. Methods：TIVA was administered in 83 cases of 168 patients in our hospital observed in this study, while sevoflurane anesthesia was used in the other patients. The myocardial conditions and postoperative recovery of patients undergoing different anesthesia methods were analyzed. Results：The cardiopulmonary bypass time, anesthesia time and operation time of the observation group were （70.02±19.23）, （48.31±15.39） and （134.49±18.19） minutes, respectively, which were significantly better than those of the control group （P〈0.05）. The resuscitation rate of the observation group （29.41%） was significantly better than that of the control group （85.95%（P〈0.05）. The total dosages of dopamine and sodium nitroprusside, urine volume and length of hospital stay of patients in the observation group were （21.1±7.5） mg, （14.6±5.3） mg, （1211±313） mL and （8.6±5.1）days, respectively, which were significantly better than those in the control group （P〈0.05）. Conclusion：As an anesthetic of inhalation anesthesia, sevoflurane is significantly better than TIVA on maintenance of myocardial function for patients in cardiac surgery, and has an ideal effect on postoperative recovery of patients. The sevoflurane anesthesia can be applied in clinical surgery.