引用本文:汤晓骁,彭 丽,张勇超.不同中医体质患者对插管全麻腹腔镜手术的反应差异比较[J].中国临床新医学,2024,17(6):673-677.
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不同中医体质患者对插管全麻腹腔镜手术的反应差异比较
汤晓骁,彭 丽,张勇超
南宁市中医医院麻醉科,广西 530000
摘要:
[摘要] 目的 比较不同中医体质患者对插管全麻腹腔镜手术的反应差异。方法 招募2019年1月至2022年9月于南宁市中医医院接受插管全麻腹腔镜腹部手术的患者119例。根据《中医体质分类与判定(ZYYXH/T157-2009)》将其分为平和质组(50例)、阳虚质组(36例)和气虚质组(33例)。比较三组麻醉诱导给药前5 min(T1)、插管时(T2)、插管完成后5 min(T3)的平均动脉压、心率,麻醉维持期丙泊酚用量以及不良反应发生率。结果 在T1~T3时间点,三组平均动脉压和心率呈下降趋势。在T2时间点,阳虚质组平均动脉压显著高于平和质组和气虚质组(P<0.05);在T1和T3时间点,三组平均动脉压比较差异无统计学意义(P>0.05)。在T1~T3时间点,三组心率比较差异无统计学意义(P>0.05)。平和质组和阳虚质组的丙泊酚用量显著高于气虚质组(P<0.05),但平和质组和阳虚质组比较差异无统计学意义(P=0.100)。气虚质组低血压发生率显著高于平和质组和阳虚质组(P<0.05)。平和质组恶心呕吐发生率显著低于阳虚质组和气虚质组(P<0.05)。三组心动过缓发生率比较差异无统计学意义(P>0.05)。结论 不同中医体质患者对插管全麻腹腔镜手术的反应存在差异,临床医师应对患者进行分类管理。
关键词:  中医体质  腹腔镜手术  插管全麻  丙泊酚
DOI:10.3969/j.issn.1674-3806.2024.06.15
分类号:R 614.2
基金项目:南宁市科学研究与技术开发计划项目(编号:20193251)
Comparison of differences in responses to laparoscopic surgery under intubation general anesthesia among
patients with different constitutions of Traditional Chinese Medicine
TANG Xiaoxiao, PENG Li, ZHANG Yongchao
Department of Anesthesiology, Nanning Hospital of Traditional Chinese Medicine, Guangxi 530000, China
Abstract:
[Abstract] Objective To compare the differences in responses to laparoscopic surgery under intubation general anesthesia among patients with different constitutions of Traditional Chinese Medicine. Methods One hundred and nineteen patients who underwent laparoscopic abdominal surgery under intubation general anesthesia in Nanning Hospital of Traditional Chinese Medicine from January 2019 to September 2022 were recruited. According to the Classification and Judgment of Traditional Chinese Medicine Constitutions(ZYYXH-T157-2009), the patients were divided into gentle constitution group(50 cases), Yang deficiency constitution group(36 cases) and Qi deficiency constitution group(33 cases). The mean arterial pressure, heart rate, propofol dosage during anesthesia maintenance and the incidence of adverse reactions were compared among the three groups 5 minutes before anesthesia induction(T1), at intubation(T2), and 5 minutes after intubation(T3). Results From the time point of T1 to the time point of T3, the mean arterial pressure and heart rate showed a downward trend in the three groups. At the time point of T2, the mean arterial pressure in the Yang deficiency constitution group was significantly higher than that in the gentle constitution group and the Qi deficiency constitution group(P<0.05). There was no significant difference in the mean arterial pressure among the three groups at the time point of T1 and the time point of T3(P>0.05). There was no significant difference in the heart rate among the three groups at the time point of T1 to the time point of T3(P>0.05). The propofol dosage in the gentle constitution group and the Yang deficiency constitution group was significantly higher than that in the Qi deficiency constitution group(P<0.05), but there was no statistically significant difference between the gentle constitution group and the Yang deficiency constitution group(P=0.100). The incidence of hypotension in the Qi deficiency constitution group was significantly higher than that in the gentle constitution group and the Yang deficiency constitution group(P<0.05). The incidence of nausea and vomiting in the gentle constitution group was significantly lower than that in the Yang deficiency constitution group and the Qi deficiency constitution group(P<0.05). There was no significant difference in the incidence of bradycardia among the three groups(P>0.05). Conclusion Patients with different constitutions of Traditional Chinese Medicine have different responses to laparoscopic surgery under intubation general anesthesia, and clinicians should conduct classified management for the patients.
Key words:  Constitution of Traditional Chinese Medicine  Laparoscopic surgery  Intubation general anesthesia  Propofol