依托咪酯联合丙泊酚诱导全麻在精神分裂症患者MECT治疗中的应用及安全性分析

Application and Safety Analysis of Etomidate Combined with Propofol in the Treatment of MECT in Patients with Schizophrenia

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DOI
刊名
Journal of International Psychiatry
年,卷(期) 2020, 47(1)
作者
作者单位

河南省濮阳市人民医院 ;

摘要
探究分析依托咪酯联合丙泊酚诱导全麻在精神分裂症(SP)患者无抽搐电休克(MECT)治疗中的应用效果及安全性。方法 选取我院96例SP患者,采用随机数字表法分为3组,各32例。A组静脉注射丙泊酚2 mg/kg麻醉全麻,B组静脉注射依托咪酯0.3 mg/kg麻醉全麻,C组静脉注射丙泊酚1 mg/kg联合依托咪酯0.15 mg/kg麻醉全麻,患者睫毛反射消失后,均静注琥珀胆碱1 mg/kg,全身肌肉松弛后行MECT治疗。对比三组运动发作时间、抽搐能量指数、抑制指数、抽搐一致性指数、不良反应发生率、不同时间点收缩压(SBP)、心率(HR)、治疗前后阳性与阴性症状量表(PANSS)、韦氏记忆量表(WMS-MQ)评分。结果 C组运动发作时间、抽搐能量指数、抑制指数、抽搐一致性指数较B组高,B组较A组高(P<0.05);T1时三组SBP、HR均降低,T2时三组SBP、HR均升高,T3、T4时三组SBP、HR均降低,T1时C组SBP、HR高于A组,B组SBP、HR高于A组,T3时C组SBP较B组、A组低(P<0.05),C组血流动力学波动小于B组、A组;治疗后C组PANSS评分低于B组、A组,B组PANSS评分低于A组,C组WMS-MQ评分高于B组、A组,B组WMS-MQ评分高于A组(P<0.05);B组躁动、肌肉震颤发生率(31.25%、34.38%)高于A组(6.25%、6.25%)、C组(6.25%、9.38%),A组注射痛发生率(37.50%)高于B组(12.50%)、C组(12.50%)(P<0.05)。结论 依托咪酯联合丙泊酚诱导全麻应用于SP患者MECT治疗中,可在保持较小血流动力学波动的情况下,保证治疗效果,对患者认知、记忆功能影响较小,且具有较高的安全性。
Abstract
Objective To investigate the efficacy and safety of etomidate combined with propofol in the treatment of schizophrenia (SP) patients without convulsion electroconvulsive (MECT). Methods Ninety-six patients with SP were enrolled in our hospital. They were randomly divided into 3 groups, 32 cases each. Group A received intravenous anesthesia with propofol 2 mg/kg anesthesia, group B received anesthesia with general anesthesia with etomidate 0.3 mg/kg, and group C received anesthesia with propofol 1 mg/kg and etomidate 0.15 mg/kg. After general anesthesia and the patients eyelash reflex disappeared, succinylcholine 1 mg/kg was intravenously administered, and MECT was treated with muscle relaxation. Compare the three groups of exercise time, convulsion energy index, inhibition index, convulsion consistency index, incidence of adverse reactions, systolic blood pressure (SBP) at different time points, heart rate (HR), positive and negative symptom scale (PANSS) before and after treatment, Wechsler Memory Scale (WMS-MQ) score. Results The seizure time, convulsion energy index, inhibition index and convulsion consistency index of group C were higher than those of group B. Group B was higher than group A (P<0.05). At T1, the three groups of SBP and HR were decreased, and T2 was three groups of SBP. The HR and HR were increased. The TBP and HR of the three groups were decreased at T3 and T4. The SBP and HR of group C were higher than that of group A at T1, the SBP and HR of group B were higher than that of group A, and the group B group of group B was higher than group B with T3. The group was low (P<0.05). The hemodynamic fluctuation of group C was lower than that of group B and group A. The PANSS score of group C was lower than that of group B and group A after treatment. The PANSS score of group B was lower than that of group A, and group C was WMS-MQ. The scores were higher than those of group B and group A. The WMS-MQ score of group B was higher than that of group A (P<0.05). The incidence of agitation and muscle tremor in group B (31.25%, 34.38%) was higher than that of group A (6.25%, 6.25%). In group C (6.25%, 9.38%), the incidence of injection pain in group A (37.50%) was higher than that in group B (12.50%) and group C (12.50%) (P<0.05). Conclusion Etomidate combined with propofol induces general anesthesia in the treatment of MECT in patients with SP, which can ensure the therapeutic effect while maintaining small hemodynamic fluctuations, and has less influence on patients cognitive and memory functions. Higher security.
关键词
精神分裂症;无抽搐电休克;依托咪酯;丙泊酚;安全性
KeyWord
Schizophrenia; No convulsion electroconvulsive; Etomidate; Propofol; Safety
基金项目
页码 104-106
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刘新生*. 依托咪酯联合丙泊酚诱导全麻在精神分裂症患者MECT治疗中的应用及安全性分析 [J]. 国际精神病学杂志. 2020; 47; (1). 104 - 106.

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