摘要目的:探讨去氧肾上腺素不同给药方式对胸腔镜全身麻醉（全麻）手术患者低血压的影响。方法:将2020年1月至2023年1月在金华市中心医院行胸腔镜全麻手术的患者120例按照随机数字表法分成对照组和观察组，对照组60例予以单次去氧肾上腺素，观察组60例持续泵注去氧肾上腺素，两组其他麻醉方法相同。观察两组的血流动力学指标（收缩压、舒张压、心率）、低血压发生率（麻醉诱导期间与手术期间）、麻醉时间与手术时间、尿量、失血量、输液量、去氧肾上腺素用量。结果:观察组首次收缩压降低 > 20%基础值时（T1）、T1后5 min（T2）的收缩压、舒张压均高于对照组［（99.77±11.42）mmHg比（95.34±15.37）mmHg、（120.49±12.48）mmHg比（113.45±16.03）mmHg；（62.60±5.81）mmHg比（59.43±6.35）mmHg、（73.61±7.01）mmHg比（70.20±8.15）mmHg］（1 mmHg=0.133 kPa），差异均有统计学意义（收缩压： t=1.79， P=0.038； t=2.68， P=0.004；舒张压： t=2.85， P=0.003； t=2.46， P=0.008）；观察组麻醉诱导期间、手术期间的低血压发生率分别为8.33%（5/60）、15.00%（9/60），均低于对照组的26.67%（16/60）、33.33%（20/60），差异均有统计学意义（χ 2=6.98， P=0.008；χ 2=5.50， P=0.019）；两组的麻醉时间与手术时间比较，差异均无统计学意义（ t=0.19， P=0.425； t=0.27， P=0.396）；两组的尿量、失血量、输液量差异均无统计学意义（ t=0.92， P=0.179； t=1.02， P=0.155； t=0.91， P=0.182）；两组去氧肾上腺素用量差异无统计学意义（ t=1.11， P=0.134）。 结论:去氧肾上腺素持续泵注在胸腔镜全麻手术患者中的应用效果优于单次给药，可稳定患者术中的血流动力学指标，且能降低低血压发生率。

abstractsObjective:To investigate the effects of different deoxyepinephrine administration methods on hypotension in patients undergoing thoracoscopic general anesthesia.Methods:A total of 120 patients undergoing thoracoscopic general anesthesia in Jinhua Municipal Central Hospital from January 2020 to January 2023 were included in this study. They were randomly divided into a control group and an observation group ( n = 60 patients per group). Patients in the control group were given deoxyepinephrine once, and patients in the observation group were continuously pumped with deoxyepinephrine. Other anesthesia methods in the two groups were the same. Hemodynamic indexes (systolic blood pressure, diastolic blood pressure, and heart rate), incidence of hypotension (during anesthesia induction and operation), anesthesia time, operation time, urine volume, blood loss, infusion volume, and dosage of deoxyepinephrine were recorded. Results:At the time at which the first systolic blood pressure decreased by > 20% of the baseline (T1) and 5 minutes after T1 (T2), the systolic blood pressures in the observation group were significantly higher than those in the control group [T1: (99.77 ± 11.42) mmHg vs. (95.34 ± 15.37) mmHg, t = 1.79, P = 0.038; T2: (120.49 ± 12.48) mmHg vs. (113.45 ± 16.03) mmHg, t = 2.68, P = 0.004; 1 mmHg = 0.133 kPa]. At T1 and T2, diastolic blood pressures in the observation group were significantly higher than those in the control group [T1: (62.60 ± 5.81) mmHg vs. (59.43 ± 6.35) mmHg, t = 2.85, P = 0.003; T2: (73.61 ± 7.01) mmHg vs. (70.20 ± 8.15) mmHg, t = 2.46, P = 0.008]. The incidences of hypotension during anesthesia induction and surgery in the observation group were 8.33% (5/60) and 15.00% (9/60), respectively, which were significantly lower than 26.67% (16/60) and 33.33% (20/60) in the control group ( χ2 = 6.98, P = 0.008; χ2 = 5.50, P = 0.019). There were no significant differences in anesthesia time ( t = 0.19, P = 0.425) and operative time ( t = 0.27, P = 0.396) between the two groups. There were no significant differences in urine volume ( t = 0.92, P = 0.179), blood loss ( t = 1.02, P = 0.155), and infusion volume ( t = 0.91, P = 0.182) between the two groups. There was no significant difference in the dosage of deoxyepinephrine between the two groups ( t = 1.11, P = 0.134). Conclusion:Continuous infusion of deoxyepinephrine in patients undergoing thoracoscopic general anesthesia yields superior efficacy than a single administration of deoxyepinephrine. The former can stabilize the hemodynamic indicators of patients during surgery and reduce the incidence of hypotension.