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目的 采用经气管多普勒超声及Ｈｏｌｔｅｒ心电监测仪观察地氟醚对冠心病病人血液动力学及ＳＴ段的影响。方法 ４０ 例ＡＳＡⅡ～Ⅲ级择期手术的冠心病病人，随机分为两组，分别吸入地氟醚（Ⅰ组）和异氟醚（Ⅱ组），所有病人麻醉前１ 小时肌肉注射哌替啶、东莨菪碱，局麻下行桡动脉及颈内静脉穿刺，用芬太尼、依托咪酯、维库溴铵诱导，２％ 利多卡因喷喉，插入多普勒气管导管，并与心输出量测定仪连接，用Ｏｈｍ ｅｄａＥｘｃｅｌ８０型全能麻醉机控制通气。用ＤＡＴＥＸ气体监测仪测定地氟醚浓度，用Ｈｏｌｔｅｒ心电监测仪（ＰＩ２００Ａ）记录心电图的变化。结果 两组的年龄、性别、身高、体重无显著差异。两组的ＭＡＰ、ＳＶＲ在０５ＭＡＣ时与基础值相比无显著变化，在０７５ＭＡＣ及１０ＭＡＣ时相比基础值明显下降，而两组的ＨＲ、ＣＶＰ、ＣＩ在不同ＭＡＣ时与基础值相比均无显著变化。Ｈｏｌｔｅｒ心电监测仪记录结果分析显示两组的ＳＴ段均无心肌缺血的征象。结论 冠心病病人吸入地氟醚浓度低于１０ＭＡＣ时，其对心血管系统影响较小，能维持血液动力学稳定，无心肌缺血现象发生
Objective To observe the effects of desflurane on hemodynamics and ST segment in patients with coronary heart disease by tracheal Doppler echocardiography and Holter ECG monitor. Methods Forty coronary artery disease patients undergoing ASA Ⅱ ~ Ⅲ elective surgery were randomly divided into two groups: inhaled desflurane (group Ⅰ) and isoflurane (group Ⅱ). All patients received intramuscular injection of pethidine 1 hour before anesthesia, Scopolamine, local anesthesia radial artery and internal jugular vein puncture, with fentanyl, etomidate, vecuronium-induced, 2% lidocaine throat, Doppler tracheal catheter inserted, and with the cardiac output detector Connect, with Ohm edaExcel80 type anesthesia machine control ventilation. The desflurane concentration was measured with a DATEX gas monitor and the electrocardiogram changes recorded with a Holter ECG monitor (PI200A). Results There was no significant difference in age, sex, height and weight between the two groups. The MAP and SVR of the two groups had no significant change from baseline at 05 MAC, but decreased significantly at 075 MAC and 1 0 MAC, while HR, CVP and CI of the two groups were significantly different from baseline No significant change compared with the baseline value. Holter ECG monitor results showed no signs of myocardial ischemia in both ST segment. Conclusion In patients with coronary heart disease inhaled desflurane concentration of less than 1 MAC, its less impact on the cardiovascular system, to maintain hemodynamic stability, no myocardial ischemia occurred