乙肝肝硬化脾切除术患者术后使用参附注射液对全麻苏醒质量的影响

Effects of shenfu injection on the awakening quality of patients with hepatitis B cirrhosis undergoing splenectomy after general anesthesia

目的:观察参附注射液对肝功能失代偿脾切除术患者术后全身麻醉苏醒的影响。方法:选取40例乙肝肝硬化、肝功能失代偿期在全麻下行脾切除的患者,ASAⅡ~Ⅲ级,随机分为两组:参附组(SFI组)及对照组(C组)。两组患者术毕麻醉未醒及无自主呼吸入麻醉后监护室(PACU)后,SFI组在患者入PACU后于10 min内静脉输注参附注射液1 m L/kg,对照组则输注等量生理盐水。记录两组患者的睁眼时间、拔管时间、PACU停留时间,并记录用药前和用药后5、15、45 min时的心率(HR)、平均动脉压(MAP)。同时记录各组患者的烦躁发生率。结果:与C组比较,SFI组的睁眼时间、拔管时间、PACU停留时间差异无显著性(P>0.05);同输注前比较,SFI及生理盐水输注后5、15、45 min的HR及MAP差异无显著性(P>0.05)。但SFI组患者的烦躁发生率明显低于C组(P<0.05)。结论 :单纯参附注射液能减少肝功能失代偿行脾切除术患者的苏醒期烦躁发生率。

Objective To observe the effects of shenfu injection （SFI） on the awakening quality of the patients with hepatitis B cirrhosis undergoing splenectomy under general anethesia. Methods Forty patients with hepatitis B c^rrhosis and hepatic insufficiency （ASA class Ⅱ- Ⅲ ） underwent splenectomy by general anesthesia. Patients were all sent into the post-anesthesia care unit（PACU） shortly after the operation with unconscious and no spontaneously breathing. They were randomly divided into two groups： SFI treatment group （Group SFI, n -- 20） and normal saline controlled group （Group NSC, n = 20）. SFI group were treated with SFI （1 mL/kg, i. v.） in 10 minutes, and NSC group were treated with normal saline （1 mL/kg,i.v.）. The time of eyes opening, extubation of tracheal catheter and the detention time of PACU were recorded. The heart rate （HR） and the average artery presses（MAP） were monitored at 4 time points： before SFI and normal saline administration, 5 min, 15 min, and 45 min after administration. The incidence of restlessness during the patients awakening period was also recorded. Results The time of eyes opening, extubation and the detention time of PACU of SFI group show no significant difference compared with the NSC group（P 〉 0.05）. SFI and normal saline intravenous injection did not cause significant changes on HR and MAP at the time of 5 min, 15 rain and 45 min compared to the time of before administration （P 〉 0.05）. The incidence of restlessness during the patients resuscitation period in SFI group were lower than in NSC group （P 〈 0.05）. Conclusion Shenfu injection can effectively improve the awakening quality and decrease the incidence of restlessness of the patients with hepatitis B cirrhosis undergoing splenectomy under general anesthesia during the awakening period in PACU.