摘要
目的研究七氟醚联合瑞芬太尼麻醉对腹腔镜下子宫肌瘤切除术患者应激反应及血流动力学的影响。方法选择2016年10月~2018年10月在中国人民解放军联勤保障部队第九〇八医院拟行腹腔镜下子宫肌瘤切除术的患者86例为研究对象,按照随机数字表法分为研究组和对照组,每组各43例。对照组采用瑞芬太尼联合丙泊酚麻醉,研究组采用瑞芬太尼联合七氟醚麻醉。比较两组麻醉前5 min(T0)、气腹后30 min(T1)、手术结束时(T2)和术后2 h(T3)的皮质醇(COR)、肾上腺素(A)、去甲肾上腺素(NA)、C-反应蛋白(CRP)及血糖(GLU)水平,T0、T1、T2时的心率(HR)、平均动脉压(MAP)、收缩压(SBP)和血氧饱和度(SpO2)等血流动力学指标和术后不良反应发生率。结果 T0~T3时,两组COR、A、NA和GLU水平均呈先升高后降低的趋势,而研究组T1和T2时各指标水平均低于对照组(P <0.05);两组CRP水平在各时间段呈不断上升趋势,研究组低于同期对照组(P <0.05)。T0~T2时的HR、MAP和SBP均呈先上升后下降趋势,且T1和T2时研究组低于对照组(P <0.05)。两组各时期的SpO2水平比较,差异无统计学意义(P> 0.05)。研究组术后不良反应的发生率(13.95%)明显低于对照组(32.56%)(P <0.05)。结论七氟醚联合瑞芬太尼麻醉下行腹腔镜下子宫肌瘤切除术可有效减轻患者术中的应激反应和血流动力学的波动,减少术后不良反应的发生。
Objective To study the effects of Sevoflurane combined with Remifentanil anesthesia on stress response and hemodynamics in patients undergoing laparoscopic hysteromyomectomy. Methods Eighty-six female patients who were scheduled to undergo laparoscopic hysteromyomectomy in 908 thHospital of the Joint Logistics Support Force of the Chinese People′s Liberation Army from October 2016 to October 2018 were selected as the study subjects. They were divided into the study group and the control group according to the random number table method, 43 cases in each group. The control group was anesthetized by Remifentanil combined with Propofol, while the study group was anesthetized with Remifentanil combined with Sevoflurane. The levels of cortisol(COR), adrenaline(A), norepinephrine(NA), C-reactive protein(CRP), and blood glucose(GLU) at 5 min before anesthesia(T0), 30 min after pneumoperitoneum(T1), the end of operation(T2), postoperative 2 h(T3), and hemodynamic parameters such as heart rate(HR),mean arterial pressure(MAP), systolic blood pressure(SBP) and oxygen saturation(Sp O2) at T0, T1 and T2, and the incidence of postoperative adverse reaction was compared between the two groups. Results The levels of COR, A, NA and GLU at T0-T3 in the two groups were increased at first and then decreased, while those at T1 and T2 of the study group were lower than those of the control group(P < 0.05);the CRP level of the two groups showed an increasing trend at each time period, and the study group was lower than that of the control group in the same period(P < 0.05). HR, MAP and SBP at T0-T2 was increased at first and then decreased, while those at T1 and T2 of the study group were lower than those of the control group(P < 0.05). There was no significant difference in Sp O2 level between the two groups at all stages(P > 0.05). The incidence of postoperative adverse reactions in the study group(13.95%) was lower than that in the control group(32.56%)(P < 0.05). ConclusionSevoflurane combined with Remifentanil anesthesia in laparoscopic hysteromyomectomy can effectively reduce the stress reaction and hemodynamic fluctuation of patients during operation, and reduce the occurrence of adverse reactions after operation.
作者
艾金莲
肖金辉
刘荣
王敏华
桂新星
AI Jinlian;XIAO Jinhui;LIU Rong;WANG Minhua;GUI Xinxing(Department of Anesthesiology,908th Hospital of the Joint Logistics Support Force of the Chinese People′s Liberation Army,Jiangxi Province,Yingtan335000,China)
出处
《中国医药导报》
CAS
2019年第31期103-106,共4页
China Medical Herald
基金
江西省卫生计生委科技计划项目(20165304)
关键词
子宫肌瘤
麻醉药吸入
精神运动性激动
血流动力学
Uterine leiomyoma
Inhalation of anesthetics
Psychomotor stimulation
Hemodynamics
