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李亦凡, 王健, 金玉燕, 邵逸, 童贻捷, 刘智慧. 依托咪酯联合丙泊酚对精神分裂症无抽搐电休克治疗患者应激反应及认知功能的影响[J]. 实用临床医药杂志, 2019, 23(13): 42-45. DOI: 10.7619/jcmp.201913012
引用本文: 李亦凡, 王健, 金玉燕, 邵逸, 童贻捷, 刘智慧. 依托咪酯联合丙泊酚对精神分裂症无抽搐电休克治疗患者应激反应及认知功能的影响[J]. 实用临床医药杂志, 2019, 23(13): 42-45. DOI: 10.7619/jcmp.201913012
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LI Yifan, WANG Jian, JIN Yuyan, SHAO Yi, TONG Yujie, LIU Zhihui. Effect of etomidate combined with propofol on stressresponse and cognitive function in schizophrenia patients with modified electric convulsive therapy[J]. Journal of Clinical Medicine in Practice, 2019, 23(13): 42-45. DOI: 10.7619/jcmp.201913012
Citation: LI Yifan, WANG Jian, JIN Yuyan, SHAO Yi, TONG Yujie, LIU Zhihui. Effect of etomidate combined with propofol on stressresponse and cognitive function in schizophrenia patients with modified electric convulsive therapy[J]. Journal of Clinical Medicine in Practice, 2019, 23(13): 42-45. DOI: 10.7619/jcmp.201913012
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依托咪酯联合丙泊酚对精神分裂症无抽搐电休克治疗患者应激反应及认知功能的影响

Effect of etomidate combined with propofol on stressresponse and cognitive function in schizophrenia patients with modified electric convulsive therapy

    摘要
  • 摘要:
      目的  探讨依托咪酯联合丙泊酚对精神分裂症无抽搐电休克治疗患者应激反应及认知功能的影响。
      方法  选择114例精神分裂症患者为研究对象，采用随机数字表法分为联合组、依托咪酯组、丙泊酚组各38例。联合组采用依托咪酯联合丙泊酚全身麻醉，依托咪酯组采用依托咪酯全身麻醉，丙泊酚组采用丙泊酚全身麻醉。比较3组应激反应、认知功能、不良反应等指标。
      结果  每次电刺激结束后，联合组精神分裂症患者的血清肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(Cor)含量显著低于依托咪酯组、丙泊酚组(P < 0.05或P < 0.01); 治疗10次后，联合组精神分裂症患者语言智商、操作智商、智商评分显著高于依托咪酯组、丙泊酚组(P < 0.05); 联合组注射疼痛、恶心、呕吐等总不良反应发生率为13.16%, 显著低于依托咪酯组的36.84%、丙泊酚组的44.74%(P < 0.05或P < 0.01)。
      结论  依托咪酯联合丙泊酚全身麻醉有助于缓解精神分裂症无抽搐电休克治疗患者的应激反应，减轻麻醉药物所致认知功能损害，降低注射疼痛、恶心、呕吐等不良反应的发生率。

     

    Abstract:
      Objective  To investigate the effect of etomidate combined with propofol on stress response and cognitive function in patients with schizophrenia treated by modified electric convulsive therapy.
      Methods  A total of 114 patients with schizophrenia were enrolled in the study, and were randomly divided into three groups: combined group(n=38), etomidate group(n=38) and propofol group(n=38). The combined group received general anesthesia with etomidate and propofol, the etomidate group underwent general anesthesia with etomidate, and the propofol group underwent general anesthesia with propofol. Stress response, cognitive function, adverse reactions and other indicators of three groups were compared.
      Results  After each electrical stimulation, the serum levels of epinephrine (E), norepinephrine (NE) and cortisol (Cor) in the combined group were significantly lower than those in the etomidate group and the propofol group (P < 0.05 or P < 0.01); after 12 times of treatments, the scores of language IQ, operation IQ, and IQ in the combined group were significantly higher than those in the other two groups (P < 0.05); the incidence of total adverse reactions such as nausea and vomiting was 13.16% in the combined group, which was significantly lower than 36.84% in the etomidate group and 44.74% in the propofol group (P < 0.05 or P < 0.01).
      Conclusion  Anesthesia with etomidate and propofol in combination can alleviate the stress response in patients with schizophrenia treated by modified electric convulsive therapy, reduce cognitive impairment caused by anesthetics, relieve pain and reduce the incidence of adverse reactions such as injection pain, nausea and vomiting.

     

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