彩色多普勒超声观察异丙酚和依托咪酯麻醉诱导前后颈总动脉及椎动脉血流动力学改变

摘要

目的 探讨异丙酚和依托咪酯麻醉诱导前后颈总动脉及椎动脉血流动力学改变.方法 选择全麻手术患者60例,随机分为异丙酚组、依托咪酯组,每组30例.应用彩色多普勒超声检测颈总动脉及椎动脉,测量收缩期峰值流速(PSV)、舒张末期流速(EDV)、血流量(BF)、平均血流速度(Vm)、舒张期内径(Dd)、收缩期内径(Ds)等.结果 异丙酚诱导后血压、心率、颈总动脉及椎动脉Dd、Ds、BF降低(P＜0.05),而PSV、EDV、Vm无明显变化(P＞0.05).依托咪酯诱导前后各指标除心率外均无明显变化(P＞0.05).结论 异丙酚较依托咪酯诱导前后颈总动脉及椎动脉BF明显降低、血流动力学改变显著.依托咪酯在稳定血流动力学方面更具优势.%Objective To explore the hemodynamics of common carotid artery and vertebral artery before and after the induction of general anesthesia of propofol and etomidate. Methods A total of 60 patients undergoing general anesthesia operation were randomly divided into propofol group and etomidate group (each n = 30). Color Doppler ultrasound was used to obtain the indexes of carotid artery and vertebral artery, including peak systolic velocity (PSV), end-diastolic velocity (EDV). Blood flow (BF), average flow velocity (Vm) , diastoltc diameter (Dd) and systolic diameter (Ds), etc. Results The blood pressure, heart rate, Dd, Ds and BF reduced after the induction of general anesthesia with propofol (P<0. 05), but PSV,EDV and Vm did not change significantly. After induction of general anesthesia with etomidate, indexes except heart rate did not change significantly (P>0. 05). Conclusion BF of carotid artery and vertebral artery decreased, and hemodynamics changed more obviously after the induction of general anesthesia with propofol than those with etomidate. Etomidate was better for hemodynamics.