陈珍爱　赵崇汉　严恺舒

【摘要】 目的：分析对接受颅脑手术的高龄患者，采用不同剂量依托咪酯复合舒芬太尼进行麻醉诱导的临床应用效果。方法：2016年7月-2018年12月，选取在笔者所在医院接受颅脑手术治疗的86例高龄患者，将全部的患者根据麻醉药物的药量平均分为高药量组（n=43）及低药量组（n=43）。前者的给药量为根据患者体重给药（0.4 μg/kg依托咪酯），后者的给药量同样根据患者体重给药（0.2 μg/kg依托咪酯），根据两组患者的体重均给予0.5 μg/kg的复合舒芬太尼进行麻醉诱导，对比两组患者的血流动力学变化以及不良反应发生率。结果：低药量组患者的平均动脉压波动明显低于高药量组（P<0.05）;低药量组患者的不良反应发生率要略低于高药量组，但组间差异无统计学意义（P>0.05）。结论：接受颅脑手术的高龄患者给予0.2 μg/kg依托咪酯复合0.5 μg/kg的复合舒芬太尼进行麻醉诱导能够使患者的血流动力学更加稳定，从而有效降低患者的不良反应发生率，是一种十分合适的给药方式。

【关键词】 颅脑手术 高龄患者 依托咪酯 舒芬太尼

doi：10.14033/j.cnki.cfmr.2020.18.050 文献标识码 B 文章编号 1674-6805（2020）18-0-02

Application of Different Doses of Etomidate Combination with Sufentanil in Anesthesia Induction of Elderly Craniocerebral Surgery/CHEN Zhenai， ZHAO Chonghan， YAN Kaishu. //Chinese and Foreign Medical Research， 2020， 18（18）： -119

[Abstract] Objective： To investigate the clinical effects of anesthesia induction in elderly patients undergoing craniocerebral surgery with different doses of Etomidate combined with Sufentanil. Method： The study object was 86 elderly patients who received craniocerebral surgery in our hospital from July 2016 to December 2018. They were divided into high-dose group （n=43） and low-dose group （n=43）. The former dose was based on the patients weight （0.4 μg/kg Etomidate）， and the latter dose was also based on the patients weight （0.2 μg/kg Etomidate）. Anesthesia induced by Sufentanil 0.5 μg/kg body weight. And the hemodynamic changes and the incidence of adverse reactions were compared between the two groups of patients. Result： The arterial pressure fluctuation of the patients in the low-dose group were significantly lower than that in the high-dose group （P<0.05）. The incidence of adverse reactions in the low dose group was slightly lower than that in the high dose group， but there was no significant difference between the two groups （P>0.05）. Conclusion： Anesthesia of elderly patients undergoing craniocerebral surgery can induce by 0.2 μg/kg Etomidate compound 0.5 μg/kg Sufentanil， which can make the patients hemodynamics more stable and effective. It is a very suitable way to reduce the incidence of adverse reactions in patients.

[Key words] Craniocerebral surgery Elderly patients Etomidate Sufentanil

First-authors address： Peoples Hospital of Xinhui District in Jiangmen City， Jiangmen 529100， China

對高龄患者颅脑手术进行麻醉诱导，有可能会对患者造成剧烈血流动力学波动，还会导致患者出现颅内压波动的问题，这就对手术带来了很大的不良影响[1]。而依托咪酯药物不会对患者的循环呼吸造成过大的抑制，能够促使患者的血流动力学处于稳定的状态[2]。因此，本次临床研究目的旨在探讨分析对接受颅脑手术的高龄患者采用不同剂量依托咪酯复合舒芬太尼进行麻醉诱导的临床应用效果，现报道如下。

1 资料……