章志刚

[摘要] 目的 分析高齡心脏病患者非心脏手术麻醉诱导中应用右美托咪定联合依托咪酯和舒芬太尼对其血流动力学的影响。 方法 该研究方便选取该院在2016年8月—2019年5月期间收治的80例高龄心脏病非心脏手术患者进行了观察，并采用数字随机法对其进行分组，一组给予依托咪酯和舒芬太尼进行麻醉诱导，一组采用右美托咪定联合依托咪酯和舒芬太尼，分别作为普通组和观察组，对比两组患者不同时段的血流动力学指标变化以及不良反应。结果 观察组患者在T2时段的HR为（67.31±5.84）次/min，SBP为（143.82±12.67）mmHg，DBP为（83.28±10.62）mmHg，在T3时段的HR为（64.37±5.84）次/min，SBP为（138.89±12.24）mmHg，DBP为（81.66±9.67）mmHg，与普通组对应数据比较（P<0.05）;但两组患者在T1和T4时段的各项血流动力学指标对比差异无统计学意义（P>0.05）;观察组患者术后不良反应发生率为7.5%（3例），低于普通组数据（χ2=4.551，P=0.034）。结论 高龄心脏病患者非心脏手术麻醉诱导中应用右美托咪定联合依托咪酯和舒芬太尼对其血流动力学的影响较小，可降低手术风险，确保血流动力学稳定，同时减少术后不良反应，建议积极应用。

[关键词] 高龄心脏病患者;非心脏手术;麻醉诱导;右美托咪定;依托咪酯;舒芬太尼;血流动力学

[中图分类号] R4          [文献标识码] A          [文章编号] 1674-0742（2020）06（a）-0097-03

Effect of Dexmedetomidine Combined with Etomidate and Sufentanil on Hemodynamics in Non-cardiac Surgery Anesthesia Induction in Elderly Patients with Heart Disease

ZHANG Zhi-gang

Department of Anesthesiology， the First People's Hospital of Honghe Hani and Yi Autonomous Prefecture， Mengzi， Yunnan Province， 661199 China

[Abstract] Objective To analyze the effect of dexmedetomidine combined with etomidate and sufentanil on the hemodynamics of non-cardiac anesthesia convenient selection in elderly patients with heart disease. Methods 80 patients with advanced heart disease and non-cardiac surgery admitted in the hospital from August 2016 to May 2019 were observed， and they were grouped by digital random method. One group was given etomidate and Sufentanil was used for induction of anesthesia. One group used dexmedetomidine combined with etomidate and sufentanil as the general group and the observation group， respectively， and compared the changes of hemodynamic indexes and adverse reactions in different periods of the two groups of patients. Results The HR in the observation group was （67.31±5.84）times/min， the SBP was （143.82±12.67）mmHg， the DBP was （83.28±10.62） mmHg， and the HR in the T3 period was （64.37±5.84）times/min， SBP was （138.89±12.24）mmHg， and DBP was （81.66±9.67）mmHg， which was significantly different from the corresponding data of the general group（P<0.05）; but the blood flow of the two groups of patients during the T1 and T4 periods， there was no significant difference in the comparison of kinetic parameters （P>0.05）; the incidence of postoperative adverse reactions in the observation group was 7.5%（3 cases）， which was lower than that in the general group（χ2=4.551，P=0.034）. Conclusion The use of dexmedetomidine combined with etomidate and sufentanil in the induction of non-cardiac surgical anesthesia in elderly patients with heart disease has a small effect on hemodynamics， which can reduce the risk of surgery and ensure stable hemodynamics. At the same time reduce postoperative adverse reactions， it is worth active application.

[Key words] Elderly patients with heart disease; Non-cardiac surgery; Anesthesia induction; Dexmedetomidine; Etomidate; Sufentanil; Hemodynamics

高龄心脏病患者身体机能下降，心脏代偿能力降低，对手术以及麻醉的耐受力较差，因此，在进行非心脏手术的过程中，必须采用合理的麻醉诱导方式，以降低手术风险，确保手术的顺利完成[1-4]。此次研究旨在分析高龄心脏病患者非心脏手术麻醉诱导中应用右美托咪定联合依托咪酯和舒芬太尼對其血流动力学的影响，为此，文章方便选取了该院在2016年8月—2019年5月期间收治的80例高龄心脏病非心脏手术患者进行分组比较，现报道如下。……