李萍,谭明祥
LI Ping,TAN Mingxiang

• 1:贵阳市妇幼保健院儿童医院麻醉科
• 2:贵州医科大学附院麻醉科

摘要(Abstract)：

目的:探讨异氟烷对中青年女性手术患者压力感受器反射敏感性的影响。方法:将择期行腰椎或下肢骨科手术的女性患者24例,随机分为对照组(不吸入异氟烷)、异氟烷0.7最低肺泡有效浓度(MAC)组、1.0 MAC组及1.3 MAC组,分别于麻醉诱导前、诱导后及达到预定MAC平稳时测定手术患者的心率(HR)、收缩压(SBP)以及平均动脉压(MAP),并计算压力反射敏感性(BRS)。结果:与对照组比较,异氟烷组HR增快(P<0.05),SBP、MAP降低(P<0.05);与0.7 MAC组比较,1.0 MAC组及1.3 MAC组SBP、MAP显著降低(P<0.05);与1.0 MAC组比较,1.3 MAC组SBP、MAP显著降低(P<0.05);与对照组比较,0.7 MAC组BRS差异无统计学意义(P>0.05),1.0 MAC组及1.3 MAC组BRS显著降低(P<0.05);与1.0 MAC组比较,1.3 MAC组的BRS值降低(P<0.05)。结论:异氟烷能抑制压力感受器反射敏感性,其对心率的影响与BRS受抑制有关。
Objective: To investigate the effects of isoflurane on baroreceptor reflex sensitivity of young and middle aged female surgical patients. Methods: Twenty-four cases of female patients undergoing lumbar or lower extremity orthopedics operation were randomly divided into 4 groups( n = 6):control group( no isoflurane),0. 7 MAC group,1. 0 MAC isoflurane group and 1. 3 MAC isoflurane group. HR,SBP,and MAP were determined before anesthesia induction( T1),after induction of anesthesia and reaching a predetermined MAC smooth( T2),and BRS(baroreflex sensitivity) was calculated. Results: Compared with control group,HR significantly increased and SBP,MAP decreased in isoflurane groups( P < 0. 05). Compared with 0. 7 MAC group,the SBP and MAP of 1. 0 MAC group and 1. 3 MAC group significantly decreased( P < 0. 05). Compared with 1. 0 MAC group,the SBP,MAP of 1. 3MAC group significantly decreased( P < 0. 05). There was no statistical difference of BRS between control group and 0. 7 MAC group( P > 0. 05) but compared with control group,the BRS of 1. 0 MAC group and 1. 3 MAC group significantly decreased( P < 0. 05). Compared with 1. 0MAC group,the BRS of 1. 3 MAC group significantly decreased( P < 0. 05) Conclusion: Isoflurane can inhibit the BRS,which may be related to its effect on HR.

关键词(KeyWords)： 异氟烷;血压;心率;压力感受器反射
isoflurane;blood pressure;heart rate;baroreceptor reflex

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 李萍,谭明祥
LI Ping,TAN Mingxiang

DOI: 10.19367/j.cnki.1000-2707.2016.02.027

参考文献(References)：

• [1]王力群,郭继鸿.压力感受器敏感性试验[J].心电学杂志,2002(1):31-53.
• [2]马宇,熊原长,包睿,等.低流量吸入地氟醚或异氟醚控制性降压对患儿压力反射敏感性的影响[J].中华麻醉学杂志,2007(1):133-135.
• [3]张萍.自主神经对心脏节律的调控[J].心电学杂志,2003(1):57-61.
• [4]Stefan H.Hohnloser.压力感受器功能的研究[J].德国医学,2000(1):29-30.
• [5]马宇,邓小明,朱科明,等.脊柱矫形术患者控制性降压时异氟烷对压力反射敏感性的影响[J].中华麻醉学杂志,2005(8):569-571.

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