文章摘要
依托咪酯持续输注对患者术后生化指标的影响
Effects of continuous infusion of etomidate on postoperative biochemical index
  
DOI：10.12089/jca.2019.10.014
中文关键词: 依托咪酯  丙泊酚  围术期  生化指标
英文关键词: Etomidate  Propofol  Perioperation  Biochemical index
基金项目:
作者单位E-mail
沈浩 100853,北京市,解放军总医院第一医学中心麻醉手术中心  
高雪莹 100853,北京市,解放军总医院第一医学中心麻醉手术中心  
曹江北 100853,北京市,解放军总医院第一医学中心麻醉手术中心  
王龙 100853,北京市,解放军总医院第一医学中心麻醉手术中心  
张宏 100853,北京市,解放军总医院第一医学中心麻醉手术中心 mazuimao301@163.com 
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中文摘要:
      
目的 通过分析静脉持续输注依托咪酯对患者术后生化指标的影响,评估其临床使用的安全性。
方法 选择我院2018年3—11月期间手术患者170例,男96例,女74例,年龄18～65岁,BMI 18～30 kg／m2,ASA Ⅰ—Ⅲ级,随机分为两组，每组85例:依托咪酯组(E组)和丙泊酚组(P组)。E组采用依托咪酯0.2～0.3 mg／kg麻醉诱导,持续输注依托咪酯6～8 μg·kg-1·min-1;P组采用丙泊酚1～2 mg／kg麻醉诱导,持续输注丙泊酚2～4 mg·kg-1·h-1。两组麻醉维持均复合吸入1%七氟醚，静脉输注瑞芬太尼0.2～0.4 μg·kg-1·min-1。记录两组术前、术后1、3 d的AST、ALT、尿素氮(BUN)、肌酐(Scr)、总胆红素(TBIL)、肌酸激酶(CK)、血糖(Glu)浓度以及术中失血量、术中尿量、术中输液量、手术时间、苏醒时间和术后住院时间。
结果 与术前比较,术后1、3 d 两组ALT、TBIL、CK、Glu浓度明显升高(P＜0.05)，BUN浓度明显降低(P＜0.05)。两组不同时点AST、ALT、Scr、CK、BUN、TBIL、Glu浓度差异无统计学意义。E组术中尿量明显少于P组(P＜0.05)。两组术中失血量、术中补液量、手术时间、苏醒时间和术后住院时间差异无统计学意义。
结论 与丙泊酚比较,采用依托咪酯麻醉诱导及术中持续静脉输注并不明显影响手术患者术后相关生化指标。
英文摘要:
      
Ojective To evaluate the clinical safety of intravenous continuous infusion of etomidate by comparing the postoperative biochemical index.
Methods A total of 170 patients undergoing surgery, 96 males and 74 females, aged 18-65 years, with a BMI 18-30 kg／m2, falling into ASA physical status Ⅰ-Ⅲ, were chosen from March 2018 to November 2018 in our hospital. They were randomly divided into two groups with 85 cases in each group: etomidate group (group E) and propofol group (group P). The patients in group E was injected etomidate at a dosage of 0.2-0.3 mg／kg, and maintained by etomidate of 6-8 μg·kg-1·min-1. The patients in group P was injected propofol at a dosage of 1-2 mg／kg, and maintained by propofol of 2-4 mg·kg-1·h-1. Both groups were combined with 1% sevoflurane and remifentanil 0.2-0.4 μg·kg-1·min-1 during the maintenance of anesthesia. AST, ALT, blood urea nitrogen (BUN), serum creatinine (Scr), total bilirubin (TBIL), creatine kinase (CK) and glucose (Glu) were recorded before surgery, 1 and 3 d after surgery. The blood loss of intra-operation, intraoperative urine, intraoperative infusion volume, the duration of operation, awakening time and postoperative hospital stay were also recorded.
Results Compared with pre operation, ALT， TBIL， CK， Glu in the two groups were significantly higher than those 1 and 3 d after surgery (P ＜ 0.05), and the BUN level in the two groups was significantly lower than those 1 and 3 d after surgery (P ＜ 0.05). There was no significant difference in AST, ALT, Scr, CK, BUN, TBIL and Glu between the two groups at each time point. The intraoperative urine in group E was significantly lower than that in group P (P ＜ 0.05). There were no significant difference in the intra operative blood loss, intraoperative infusion volume, the duration of operation, awakening time and postoperative hospital stay between the two groups.
Conclusion Compared to propofol, there are no obviously influences on the relative biochemical index for non-hepatobiliary patients whose anesthesia are induced and maintained by etomidate.
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