两种麻醉方法在风湿性心脏病患者二尖瓣置换术中的应用比较

目的对比七氟醚全程吸入麻醉与丙泊酚全程靶控输注麻醉在风湿性心脏病患者二尖瓣置换术中的应用效果。 方法选取2015年3月至2018年4月胶州市人民医院行风湿性心脏病患者116例，均行二尖瓣置换术，依照麻醉方式不同分为七氟醚组(58例)与丙泊酚组(58例)。丙泊酚组接受丙泊酚全程靶控输注麻醉，七氟醚组接受七氟醚全程吸入麻醉。观察对比两组意识消失时间、拔管时间及不同时点心肌酶[肌酸激酶同工酶(CK－MB)、心肌钙蛋白Ⅰ(cTnⅠ)]水平。 结果麻醉后七氟醚组意识消失及拔管时间短于丙泊酚组(P<0.05)；T₁～T₃七氟醚组血清cTnⅠ水平低于丙泊酚组(P<0.05)；T₃七氟醚组血清CK－MB水平低于丙泊酚组(P<0.05)。 结论与丙泊酚全程靶控输注麻醉相比，七氟醚全程吸入麻醉应用于风湿性心脏病患者二尖瓣置换术中可有效缩短意识消失及拔管时间，减轻心肌损伤。

Comparison of two anesthesia methods for mitral valve replacement in patients with rheumatic heart disease

ObjectiveTo compare the clinical efficacy of two anesthesia methods for mitral valve replacement in patients with rheumatic heart disease. MethodsA total of 116 patients with rheumatic heart disease in Jiaozhou People's Hospital from March 2015 to April 2018 were selected. All patients underwent mitral valve replacement. They were divided into sevoflurane group (58 cases) and propofol group (58 cases) according to different anesthetic methods. The propofol group received propofol target controlled infusion anesthesia, and the sevoflurane group received sevoflurane inhalation anesthesia. The levels of myocardial enzymes (CK-MB, cTn I) at different time points and the time of consciousness disappearance were observed and compared between the two groups. ResultsAfter anesthesia, the disappearance of consciousness and extubation time of sevoflurane group were shorter than those of propofol group (P<0.05); serum cTnⅠ level of T₁-T₃ sevoflurane group was lower than that of propofol group (P<0.05); serum CK-MB level of T₃ sevoflurane group was lower than that of propofol group (P<0.05). ConclusionCompared with propofol target controlled infusion anesthesia, sevoflurane inhalation anesthesia can effectively shorten the time of consciousness loss and extubation and reduce myocardial injury in patients with rheumatic heart disease undergoing mitral valve replacement.