依托咪酯乳剂联合地佐辛在心脏病病人无痛人流中应用

Clinical application of etomidate emulsion combined with dezocine in painless abortion for heart disease patients

目的探讨依托咪酯乳剂联合地佐辛在心脏病病人的无痛人流中应用的临床效果。方法选择接受无痛人工流产的心脏病病人60例,随机法分为A、B、C三组,每组各20例。A组采用依托咪酯乳剂+地佐辛麻醉;B组采用丙泊酚+地佐辛麻醉;C组采用依托咪酯乳剂+芬太尼麻醉,记录麻醉前(T1)、注射依托咪酯乳剂和丙泊酚后1 min(T2)、手术开始后1 min(T3)和3 min(T4)、手术结束(T5)时血压、心率、脉搏、氧饱和度;观察麻醉效果和麻醉恢复情况,记录各种不良反应。结果 T2时A、B两组患者比较,A组SBp、DBp、MAp、HR、Sp O2下降幅度小于B组,差异有统计学意义(P<0.01);T2时A、C两组患者比较,两组患者的SBp、DBp、MAp、HR下降幅度差异无统计学意义(P>0.05),A组Sp O2下降幅度小于B组,差异有统计学意义(P<0.01);三组患者麻醉效果、麻醉恢复情况无明显差别,不良反应统计中A组出现麻醉药物注射痛较B组少及A组出现肌震颤较B组多,差异有统计学意义(P<0.01)。结论依托咪酯乳剂联合地佐辛麻醉对呼吸、循环无明显抑制,起效快,代谢迅速、苏醒质量好和不良反应少,更适用于心脏病病人的无痛人流。

Objective To explore clinical effects of etomidate emulsion combined with dezocine in painless abortion for heart disease patients.Methods Sixty heart disease patients received painless abortion were randomly divided into group A（etomidate emulsion combined with dezocine,n=20）,group B（propofol combined with dezocine,n=20） and group C（etomidate emulsion combined with fentanyl,n=20）.BP、HR、P、SpO2 were recorded before anesthesia（T1）, 1min after injection of etomidate and propofol（T2）,1min（T3） and 3min（T4） after operation, at the end of the operation （ T5 ） .Observed the effect of anesthesia and anesthesia recovery, record adverse reactions of various.Results The SBP, DBP, MAP, HR, SpO2 of group A were decreased less than group B at T2, the differences were statistically significant （P〈0.01）.The decline of the SBP, DBP, MAP, HR were notsignificant difference between group A and group C at T2（P〉0.05）.The decrease of SpO2 in group A were less than group B, the difference was statistically significant （P〈0.01）.There were no statistically significant difference of anesthesia effect and recovery among the three groups.The anesthesia drug injection pain of group A less than that of group B,and the muscle tremor of group A more than that of group B, the differences were statistically significant （ P 〈0.01 ） . Conclusions For no significant inhibition on circulation and respiration,rapid action, rapid metabolism, good recoveryquality and less adverse reaction, etomidate emulsion combined with dezocine is better for heart disease patients in painless abortion.