主动脉开放前吸入七氟烷与靶控输注丙泊酚在心脏瓣膜置换术中的效果

Effects of Sevoflurane Inhalation before Aortic Opening and Propofol Target Controlled Infusion in Heart Valve Replacement

目的:探讨主动脉开放前吸入七氟烷与靶控输注丙泊酚在心脏瓣膜置换术中的应用效果。方法:选取2019年1月-2021年6月桂林医学院附属医院收治的100例接受心脏瓣膜置换术的患者作为研究对象。按抛硬币随机法将其分为对照组和观察组,各50例。两组术前接受标准化麻醉诱导,对照组接受主动脉开放前吸入七氟烷维持麻醉,观察组接受靶控输注丙泊酚注射液维持麻醉。比较两组各个时间点血流动力学指标,术前及术后1 d血糖指标及相关指标。结果:T_(2)~T_(4),对照组平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)、中心静脉压(central venous pressure,CVP)、心脏指数(cardiac index,CI)高于观察组,差异均有统计学意义(P<0.05)。两组术前及术后1 d糖化血红蛋白(glycosylated hemoglobin,HbA1c)、空腹血糖(fasting plasma glucose,FPG)比较差异均无统计学意义(P>0.05)。观察组苏醒时间、拔管时间、自主呼吸时间均早于对照组,Richmond躁动-镇静评分(Richmond agitation-sedation scale,RASS)评分低于对照组,差异均有统计学意义(P<0.05)。结论:心脏瓣膜置换术中应用靶控输注丙泊酚效果较好,对患者血流动力学影响较小,临床效果明显,值得推广应用。

Objective:To investigate the application effects of Sevoflurane inhalation before aortic opening and Propofol target controlled infusion in cardiac valve replacement.Method:A total of 100 patients who underwent cardiac valve replacement in the Affiliated Hospital of Guilin Medical College from January 2019 to June 2021 were selected as the research objects.They were divided into control group and observation group according to the coin tossing random method,with 50 cases in each group.The two groups received standardized anesthesia induction before operation,the control group received Sevoflurane inhalation before aortic opening to maintain anesthesia,and the observation group received target controlled infusion of Propofol Injection to maintain anesthesia.Hemodynamic indexes at each time point,blood glucose indexes 1 day before and after operation and related indexes were compared between the two groups.Result:From T_(2) to T_(4),the mean arterial pressure(MAP),the heart rate(HR)and central venous pressure(CVP),the cardiac index(CI)of the control group were higher than those of the observation group,the differences were statistically significant(P<0.05).There were no significant differences in glycosylated hemoglobin(HbA1c)and fasting plasma glucose(FPG)between the two groups 1 day before and after operation(P>0.05).The recovery time,extubation time and spontaneous breathing time of the observation group were earlier than those of the control group,and the Richmond agitation sedation scale(RASS)score was lower than that of the control group,the differences were statistically significant(P<0.05).Conclusion:The application of Propofol target controlled infusion anesthesia in heart valve replacement has a better effect,has less influence on patient hemodynamics,and has a clear clinical effect,which deserves to be promoted and applied.