不同剂量氯胺酮联合异丙酚对精神分裂症患者改良电休克治疗的影响

摘要

Objective To investigate the effect of different doses of ketamine combined with propofol in the treatment of schizophrenia patients with modified electroconvulsive therapy (ECT),and to definite the dose-effect relationship between ketamine and seizure duration in patients with schizophrenia.Methods Twenty-two schizophrenia patients who need ECT were given propofol and different doses of ketamine (0.0,0.1,0.2 and 0.4 mg/kg) randomly at initial 4 ECT sessions.The patients' vital signs at different time points,the dose of propofol,the motor and EEG seizure time,the consciousness and orientation recovery time,and the side effects were observed.Results There is no statistic difference of vital signs,seizure times and recovery times among different doses of ketamine groups (P＞0.05).Only the propofol dose in ketamine 0.0 mg/kg group is higher than other three groups (P=0.038).Conclusion In this trial,ketamine dosen't improve the seizure of ECT for schizophrenia patients,and there is no dose-effect relationship between ketamine and seizure duration.%目的 将不同剂量的氯胺酮与异丙酚联合,用于精神分裂症患者的电休克治疗,观察氯胺酮对电休克治疗发作的影响及与发作持续时间之间的量效关系.方法 根据氯胺酮剂量不同,将其分为四组:异丙酚+氯胺酮0.0mg/kg、异丙酚+氯胺酮0.1mg/kg、异丙酚+氯胺酮0.2mg/kg和异丙酚+氯胺酮0.4mg/kg.纳入的22例患者在最初的4次改良电休克治疗时,每次均随机给予上述药物组合之一.记录患者各时点生命体征,异丙酚的使用量,抽搐发作时间、脑电发作时间,意识恢复时间、定向力恢复时间以及不良反应发生情况.结果 各剂量组各时点生命体征以及发作、恢复时间之间的差异没有统计学意义(P＞0.05)；仅氯胺酮0.0mg/kg组的异丙酚使用量高于其它三组,差异有统计学意义(P=0.038).结论 氯胺酮未能改善精神分裂症患者电休克治疗的发作,氯胺酮的剂量与电休克发作持续时间之间未发现存在量效关系.