围手术期应用依托咪酯与异丙酚对老年肿瘤患者心、肾功能影响的比较

Comparison of effects of etomidate and propofol on cardiac and renal function in perioperative elderly patients

目的：探讨围手术期应用依托咪酯与异丙酚对老年肿瘤患者心、肾功能的影响。方法选取宁夏医科大学总医院2013年8月～2014年12月的确诊为恶性肿瘤并接受手术治疗的老年患者120例，根据随机数字表法随机分为2组：依托咪酯组（ T组）60例，予依托咪酯进行麻醉诱导；异丙酚组（ B组）60例，予异丙酚进行麻醉诱导。比较2组患者血流动力学、肾脏功能及围手术期各指标的变化。结果与诱导前比较，麻醉诱导后2组患者收缩压（ systolic blood pressure，SBP）、舒张压（ diastolic blood pressure， DBP）及心率（heart rate，HR）较低（P＜0.05），与依托咪酯组同时间比较，异丙酚组SBP、DBP及HR较低（P＜0.05）。与诱导前比较，诱导后2组每搏指数（stroke index，SI）、心脏指数（cardiac，index，CI）及射血速率（ejection velocity，EV）较低（P＜0.05），与依托咪酯组同期比较，异丙酚组SI、CI及EV较低（P＜0.05），与异丙酚组比较，依托咪酯组肌酐（creatinine，Cr）、尿素氮（blood urea nitrogen， BUN）及β2微球蛋白（β2-microglobulin，β2-MG）浓度较低（ P＜0.05）。结论依托咪酯对心血管系统的抑制作用小，肾脏功能损害小，对老年肿瘤患者具有重要意义。

Objective To compare the effect of etomidate and propofol on cardiac and renal function in perioperative elderly patients. Methods 120 perioperative elderly patients were selected and divided into two groups.60 cases in etomidate group （T group） were anesthesia induced by etomidate, and 60 cases in propofol group （ B group） were anesthesia induced by propofol.Hemodynamics, renal function and perioperative indexes were compared after operation.Results Compared with before induction, SBP, DBP and HR were lower after induction（P〈0.05）, and compared with T group at the same time, SBP, DBP and HR of B group were lower（ P〈0.05）.Compared with before induction, SI, CI and EV were lower after induction （P〈0.05）, and compared with T group at the same time, SI, CI and EV of the B group were lower（P〈0.05）.Compared with B group, Cr, BUN and β2-MG of T group were lower （ P〈0.05 ） .Conclusion The effects of etomidate on inhibition of cardiovascular system and damage of renal function is slighter, which has important significance for elderly cancer patients.