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目的 评价国人应用固定或改变目标血药浓度的普鲁泊福 (异丙酚 )目标控制输注 (TCI)系统的性能。方法 自行编制以药代动力学模型为基础的控制程序 ,使用Marsh的普鲁泊福参数 ,通过佳士比 3 40 0注射泵控制普鲁泊福的静脉给药速度。 2 3例择期手术病人 ,分为A、B两组 ,A组给药过程中固定目标血药浓度 ;B组给药过程中改变目标浓度4次。间断采动脉血 ,HPLC荧光法测定血药浓度。结果 313个血标本的执行误差的中位数 (MDPE) =2 6 % ,执行误差绝对值的中位数 (MDAPE) =2 2 3 % ,分散度 (divergence)= - 1 5 0 %·h-1,摆动度 (wobble) =2 2 5 %。A、B两组间MDPE差异有显著性 (P <0 0 5 )。进一步分析去除血药浓度调高后 5min内的数据 ,则两组MDPE差异无显著性 (P>0 0 5 )。结论 使用Marsh的参数进行普鲁泊福TCI麻醉 ,系统的总体性能较好。给药方案与采血时点对性能分析结果产生影响
Objective To evaluate the performance of a controlled-infusion (TCI) system of propofol (Propofol) targeting Chinese using either fixed or modified target plasma concentrations. Methods The pharmacokinetic model-based control program was self-compiled and the propofol parameters of Marsh were used to control the intravenous administration rate of propofol by using a 40 40 syringe pump. Twenty-three patients undergoing elective surgery were divided into two groups: group A and group B. Group A received a fixed target blood concentration during drug administration; group B changed the target concentration four times during drug administration. Blood was collected intermittently and plasma concentration was measured by HPLC fluorescence. Results The median of execution error (MDPE) of 313 blood samples was 26%, the median of execution error absolute value (MDAPE) was 2223%, and the degree of divergence was -1500% -1, wobble = 2 2 5%. The difference of MDPE between A and B groups was significant (P <0.05). Further analysis to remove the blood concentration within 5min after the increase in data, the two groups had no significant difference in MDPE (P> 0 05). Conclusion Using Marsh parameters for propofol TCI anesthesia, the overall system performance is better. Dosing regimen and blood collection point impact on the performance analysis results