七氟醚对冠状动脉旁路移植术患者心肺功能的影响

目的:探讨七氟醚对冠状动脉旁路移植术(CABG)患者心肺功能的影响。方法:选择行CABG治疗的冠心病患者60例,随机分为观察组与对照组,每组各30例,两组患者均采用静脉全麻,全麻后对照组仅给予面罩吸氧,生理盐水维持静脉通道通畅;观察组于体外循环心肺转流(CPB)开始即洗入1%七氟醚辅助麻醉,维持至CPB结束,观察麻醉前30min(T0)、术后2h(T1)、6h(T2)、24h(T3)、48h(T4)心肺功能变化。结果:1T1、T2、T3时间段观察组平均动脉压(MAP)、心率(HR)、左室射血分数(LVEF)低于对照组,T1-T4时间段观察组肌酸激酶同工酶(CK-MB)低于对照组,比较差异有统计学意义(P0.05);2T1、T2时间段两组患者潮气量(Vt)、肺活量(Vc)、氧合指数(PaO_2/FiO_2)降低,呼吸频率(RR)、肺泡-动脉血氧分压差(PA-aO_2)呈增高趋势,T3、T4时间段下降;T1、T2时间段观察组Vt、Vc高于对照组,RR低于对照组,T1-T4时间段观察组PaO_2/FiO_2高于对照组,PA-aO_2低于对照组,两组比较差异均有统计学意义(P0.05)。结论:七氟醚有助于维持CABG患者围术期心功能稳定,减轻心肌损伤,改善呼吸抑制。

Effects of Sevoflurane on Cardiopulmonary Function in Patients with Coronary Artery Bypass Grafting

Objective:To investigate the effects of sevoflurane on cardiopulmonary function in patients with coronary artery bypass grafting (CABG).Methods:Selected 60 cases of patients with coronary heart disease patients treated with CABG, which were randomly divided into observation group and control group, with 30 cases of patients in each group, two groups of patients were treated with intravenous anesthesia, after general anesthesia, the control group was only given mask oxygen inhalation, and maintained patency of the venous channels by physiological saline; while the observation group was given 1%sevoflurane assisted anesthesia at began of extracorporeal cardiopulmonary bypass (CPB), and last to the end of CPB, observed the changes of cardiopulmonary function at 30 min before anesthesia(T0), 2h(T1), 6h(T2), 24h (T3), 48(T4) after operation.Results:The mean artery pressure(MAP), heart rate(HR), left ventricular ejection fraction (LVEF) of patients in the observation group were lower than that of the control group at T1, T2, T3 times, the serum creatine kinase (CK-MB) of the observation group were lower than the control group at T1-T4 times, the difference between the two groups had statistical significance (P<0.05); The tidal volume (Vt), vital capacity (Vc), arterial oxygen tension/Inspired oxygen fraction (PaO2/FiO2)of patients in the two groups were decreased,respiratory rate (RR), alveolar-arterial blood oxygen partial pressure difference (PA-aO2) was increased at T1, T2 times, while T3 and T4 times were decreased; The Vt,Vc of the observation group were higher than that of the control group at T1 and T2 times, RR lower than the control group, the PaO2/FiO2 of the observation group was higher than that of the control group, PA-aO2 was lower than the control group at T1-T4 times, the difference between the two groups had statistical significance (P< 0.05).Conclusion:Sevoflurane is helpful to maintain stable operation peri cardiac function in patients with CABG, reduce myocardial injury, and improve the respiratory inhibition.