体外循环下二尖瓣置换术患者应用依托咪酯全凭静脉麻醉的效果研究

Effect of Total Intravenous Anesthesia with Etomidate in Patients Undergoing Mitral Valve Replacement under Cardiopulmonary Bypass

目的研究分析在体外循环下二尖瓣置换术患者中采取依托咪酯全凭静脉麻醉的临床价值。方法选取在湖南省郴州市第一人民医院接受治疗的风湿性二尖瓣病变的患者作为研究对象,选取时间段为2014年1月—2018年12月,病例数为56例。随机分组为观察组和对照组,各28例,两组患者均行体外循环下行二尖瓣置换术,对照组患者接受丙泊酚全凭静脉麻醉,观察组患者接受依托咪酯全凭静脉麻醉。分析两组患者停止转机之后不同时间点硝普钠的泵注速度以及间羟胺的使用情况,对比转机时间、到ICU后的苏醒时间以及停留时间。结果观察组的转机时间与对照组比较差异无统计学意义(P>0.05),而苏醒时间以及ICU停留时间显著高于对照组(P<0.05)。观察组中有4例使用间羟胺(14.29%),显著低于对照组17例(60.71%)(P<0.05)。观察组患者在各时间点下的硝普钠的泵入速度均显著高于对照组(P<0.05)。结论临床上在接受体外循环下二尖瓣置换术的患者中采用依托咪酯全凭静脉麻醉效果良好,与丙泊酚相比其循环抑制程度较轻,有利于减少ICU停留时间。

Objective To explore effective prevention and control strategies of nosocomial infection caused by hand hygiene in order to better control the nosocomial infection rate.Methods This study was conducted from January 2014-December 1818,with May 2016 as the boundary.After that,the management of prevention and control of nosocomial infection caused by hand hygiene was strengthened.The changes of hand hygiene awareness,hand hygiene compliance and nosocomial infection rate before and after the implementation of management were compared and analyzed.Results After strengthening the management of hand hygiene prevention and control in the hospital,the qualified rate of hand hygiene knowledge,the qualified rate of correct seven-step hand washing and the compliance of hand hygiene of medical workers have been significantly improved,which is different from that before implementation(P<0.05),and has certain statistical significance.The incidence of nosocomial infection was also significantly reduced,and there was significant difference between the two groups(P<0.05).Conclusion Strengthened management of prevention and control of nosocomial infections caused by hand hygiene is an effective strategy to reduce nosocomial infections,and it is worth popularizing and applying in the future.