术前输注头孢呋辛钠后不同靶控浓度丙泊酚对妇科手术患者心室复极的影响

Effects of target-controlled infusion of propofol with different concentrations on ventricular repolarization after preoperative infusion of cefuroxime sodium in patients undergoing gynecologic operation

目的观察术前预防性输注头孢呋辛钠后不同靶控浓度丙泊酚对妇科手术患者心室复极的影响。方法选择择期妇科手术患者59例,年龄18~65岁,ASAⅠ或Ⅱ级,采用随机数字表法分为三组。入室补液并静滴头孢呋辛钠2.5g（溶于100ml生理盐水中）后,分别泵注丙泊酚血浆靶控浓度为2μg/ml（P2组,n=20）、3μg/ml（P3组,n=19）、4μg/ml（P4组,n=20）。分别在抗生素输注前（T_0）、抗生素输注完毕（T_1）、及丙泊酚达到靶控浓度时（T_2）,测量并计算QT间期、QTc间期、T波峰值至终点时间（T_p-e间期）及Tp-e/QT。结果与T0时比较,T_1时P4组QTc间期[（469.9±34.0）ms vs.（451.2±24.9）ms]、Tp-e间期[（107±25）ms vs.（94±20）ms]、Tp-e/QT（0.260±0.058vs.0.236±0.043）明显延长（P〈0.05）;与T_1时比较,T_2时P2组[（437.4±24.4）ms vs.（453.3±28.0）ms]和P4组[（438.8±29.9）ms vs.（469.9±34.0）ms]QTc间期明显缩短（P〈0.05）。结论丙泊酚可改善头孢呋辛钠引起的心室复极不均一性。

Objective To investigate the effects of target-controlled confusion of propofol with different concentrations on ventricular repolarization after prophylactic infusion of cefuroxime sodium.Methods Sixty ASA physical status Ⅰ orⅡ female patients,aged 18-65 years,undergoing elective gynecological surgery were randomly divided into three groups：group P2（n=20）with TCI 2μg/ml,group P3（n=19）with TCI 3μg/ml and group P4（n=20）with TCI 4μg/ml.Firstly,they were rehydrated;secondly,the patients in groups P2,P3 and P4were intravenous infused with cefuroxime sodium 2.5g（in 100 ml normal saline）and then target-controlled infused of propofol 2μg/ml,3μg/ml and 4μg/ml in target plasma concentration,respectively.At three pionts of time：after rehydration before intravenous antibiotics（T_0）,after intravenous antibiotics before TCI of propofol（T_1）,after TCI of propofol（T_2）,QT_ interval,QTc interval,T_p-e interval were measured and recorded,respectively.Results Compared with T_0,QTc [（469.9±34.0）ms vs.（451.2±24.9）ms],T_p-e[（107±25）ms vs.（94±20）ms]and T_p-e/QT_（0.260±0.058 vs.0.236±0.043）in group P4 were significantly prolonged at T_1（P〈0.05）.Compared with T_1,QTc of groups P2 [（437.4±24.4）ms vs.（453.3±28.0）ms]and P4[（438.8±29.9）ms vs.（469.9±34.0）ms]were shortened significantly at T_2（P〈0.05）.Conclusion Propofol could improve ventricular reporlarization heterogeneity caused by cefuroxime sodium.