摘要
目的 探讨麻醉诱导过程中吸人不同浓度七氟烷对紫绀型及非紫绀型先天性心脏病小儿自主呼吸的影响.方法 先天性心脏病患儿33例,其中紫绀组患儿15例,非紫绀组患儿18例.给予面罩吸入6％七氟烷,记录2组患儿睫毛反射消失时间（麻醉诱导时间）.当七氟烷最低肺泡有效浓度（ MAC）达2 MAC（ M2）、1.5 MAC（M1.5）、1 MAC （M1）、0.5 MAC（M0.5）点时,分别维持5 min,记录2组患儿吸频率（RR）、潮气量（Vt）、呼气末二氧化碳（ PET CO2）.结果 紫绀组麻醉诱导时间（78±34）s,与PET CO2和SpO2呈负相关性（r1=-0.669,P＜0.05；r2=-0.789,P＜0.01）.非紫绀组麻醉诱导时间（41±18）s,与紫绀组比较明显缩短,差异有统计学意义（P＜0.01）,且与PET CO2和SpO2无相关性（r1=0.540,r2=-0.459,均P＞0.05）.非紫绀组Vt均低于紫绀组,以M2点最明显[（42±26）ml比（61±29） ml,P＜0.05].紫绀组RR在M0.5、M1两点明显低于非紫绀组（P＜0.05或P＜0.01）.紫绀组PET CO2各浓度点无变化（均P＞0.05）,而非紫绀组PET CO2在M2点明显低于M1 [（31±5）mm Hg（1 mm Hg =0.133 kPa）比（34±7） mm Hg,P＜0.05],组间各点紫绀组均低于非紫绀组,以M0.5、M1两点更明显（均P＜0.05）.结论 非紫绀组七氟烷麻醉诱导时间明显短于紫绀组；随着吸入七氟烷浓度的增加,患儿自主呼吸抑制作用加重,紫绀型较非紫绀型患儿自主呼吸抑制作用轻.
Objective To compare the effect of different concentration sevofinrane on spontaneous respiration following cardiac surgery in infants with cyanotic and non-cyanotic congenital heart disease. Methods Thirty- three cases, including fifteen cyanotic （ cyanotic group） and eighteen non-cyanotic （ non-cyanotic group） congenital heart disease infants scheduled for cardiac surgery, were studied. All infants were given inhalation anesthesia by face mask with 6% sevoflurane. The time from beginning of inhalation to eyelash reflex disappearance was recorded for the two groups. The minimal alveolar concentration （MAC） of sevoflurane was maintained at 2.0 MAC, 1.5 MAC, 1 MAC, 0.5 MAC for 5 rain respectively. The respiratory rate （RR）, tidal volume（Vt） and end-expiratory carbon dioxide tension（ PETCO2 ） at every concentration point were measured and recorded. Results The time of anesthetic induction in cyanotic group was 43-130 （78 ± 34） s, showing a negative correlation with PETCO2 and SpO2 （ rt = -0.669, P 〈 0.05 ; r2 = -0.789, P 〈 0.01 ）. The time of anesthetic induction in non-cyanotic group was 20-58 （41 ± 18 ）s, which was reduced significantly compared with cyanotic group（ P 〈 0.01 ）, but had no correlation with PETCO2 and SpO2 （ r1 = 0. 540, r2 = -0. 459; all P 〉 0.05 ）. The Vt in non-cyanotic group at every concentration points was lower than that in cyanotic group, especially at 2.0 MAC of sevoflurane [ （42 ± 26 ） ml vs （61 ± 29 ） ml, P 〈 0.05 ]. The RR in cyanotic group at 0.5 MAC and 1.0 MAC was lower than that in non-cyanotic group （ P 〈 0.05 or P 〈0.01 ）. The PETCO2 at every concentration points had no difference in cyanotic group（ all P 〉 0.05 ）, but the PETCO2 at 2.0 MAC in non-cyanotic group was decreased significantly than that at 1.0 MAC[ （31 ±5）mm Hg vs （34 ± 7 ） mm Hg, P 〈 0.05 ]. Also, the PETCO2 at every concentration points in cyanotic group was lower than that in non-cyanotic group, especially at 0.5 MAC and 1.0 MAC （ all P 〈 0.05 ）. Conclusion The time of anesthetic induction by sevoflurane in non-cyanotic group is reduced significantly than that in cyanotic group, and the degree of respiration inhibitory in non-cyanotic is decreased.
出处
《中国医药》
2012年第5期610-612,共3页
China Medicine
关键词
七氟烷
诱导
婴幼儿
自主呼吸
心脏手术
Sevoflurane
Induction
Infant
Spontaneous respiration
Cardiac surgery
