依托咪酯麻醉诱导在异位妊娠失血性休克患者的应用

Application of anesthesia induction with etomidate in ectopic pregnancy patients with hemorrhagic shock

目的探讨依托咪酯麻醉诱导在异位妊娠失血性休克患者的应用效果。方法 129例异位妊娠失血性休克患者采用静-吸复合麻醉,麻醉诱导分别用依托咪酯0.2mg/kg(E组,67例)和丙泊酚1.0~1.5mg/kg(P组,62例)。比较两组术中血压波动、出入量、术后并发症及住院时间。结果 E组术前MAP低于P组[(58.3±12.5)mmHg vs.(70.8±7.7)mmHg](P<0.05),麻醉诱导后两组MAP相仿[(51.7±7.7)mmHg vs.(53.8±10.6)mmHg](P>0.05)。E组出血量[(1895.5±678.6)ml vs.(1691.8±427.5)ml]、输注红细胞[(6.2±2.4)U vs.(4.2±1.6)U]及血浆量[(328.0±93.6)ml vs.(260.0±60.4)ml]均多于P组(P<0.05)。两组术后并发症发生率和住院时间均无统计学差异(P>0.05),两组均未出现死亡病例。结论与丙泊酚比较,异位妊娠失血性休克患者采用依托咪酯麻醉诱导能较好地维持循环稳定。

Objective To investigate the efficacy of anesthesia induction with etomidate in the ectopic pregnancy patients with hemorrhagic shock.Methods A total of 129 ectopic pregnancy patients with hemorrhagic shock underwent surgery under combined intravenous and sevoflurane inhalation anesthesia,which was induced with etomidate 0.2mg/kg（group E,67cases）or propofol1.0-1.5 mg/kg（group P,62cases）.Intraoperative blood pressure fluctuations,blood transfusion volume,urine output,postoperative complications and hospital stay were compared between two groups.Results The MAP was lower in group E than that in group P before operation[（58.3±12.5）mmHg vs.（70.8±7.7）mmHg]（P〈0.05）,which was similar after anesthesia induction[（51.7±7.7）mmHg vs.（53.8±10.6）mmHg]（P〉0.05）.The blood loss was more in group E than that in group P[（1895.5±678.6）ml vs.（1691.8±427.5）ml]（P〈0.05）.So did the RBC and plasma tranfusion[（6.2±2.4）U vs.（4.2±1.6）U and（328.0±93.6）ml vs.（260.0±60.4）ml]（P〈0.05）.There were no significant differences in the incidence of postoperative complications and hospital stay between two groups（P〉0.05）.No death case occurred in two groups.Conclusion Anesthesia induction with etomidate is better than that with propofol in maintaining circulation stability in the ectopic pregnancy patients with hemorrhagic shock.