七氟醚和异氟醚麻醉在腹腔镜手术中对应激反应的影响  

Stress Responses of Sevoflurane and Isoflurane Inhaled Anesthesia in Laparoscope Cholecystectomy

作　　者：杨昶[1] 何林[1] 左友波[2] 杨平[2] 胡有智[2] 胡建会[2] 

机构地区：[1]攀枝花市中心医院,四川攀枝花617067 [2]川北医学院附属医院,四川南充637000

出　　处：《川北医学院学报》2011年第1期38-40,共3页Journal of North Sichuan Medical College

摘　　要：目的:比较七氟醚和异氟醚麻醉在腹腔镜胆囊切除术(laparoscope cholecystectomy,LC)中对应激反应的影响。方法:60例ASAⅠ-Ⅱ级择期行LC术患者随机分成七氟醚组(S组)和异氟醚组(I组)。于诱导前和术后清醒时检测两组患者皮质醇(CORTISOL)及血糖(GLU)水平;同时记录诱导前(T1)、气腹前(T2)、气腹后5 min(T3)、气腹后10 min(T4)和苏醒时(T5)的血压和心率。结果:S组拔管时的皮质醇和血糖浓度较诱导前无明显增加(p<0.05),且较I组低。I组除气腹前血压低于诱导前外,气腹后5 min、气腹后10 min、苏醒时的血压和心率均高于诱导前,并且高于相应时点S组值(p<0.05)。结论:七氟醚较异氟醚更能有效的抑制LC术中应激反应,且血流动力学更平稳。Objective：To observe the effects of stress responses of sevoflurane and isoflurane inhaled anesthesia in laparoscope cholecystectomy.Methods： Sixty ASA I-II patients arranged for laparoscope cholecystectomy were randomly divided into two groups,sevoflurane group（S group,n=30） and isoflurane group（I group,n=30）.Cortisone and blood glucose were measured before anesthesia induction and after surgery.Systolic blood pressure（SBP）,mean arterial pressure（MAP）,diastolic blood pressure（DBP） and heart rate（HR） were recorded at the following points,before anesthesia induction（T1）,before pneumperitneum（T2）,5 min after pneumoperitoneum（T3）,10 min after pneumoperitoneum（T4） and the end of operation（T5）.Results： Cortisone and blood glucose increased were compared with before anesthesia induction in S group,and were higher than those in I group.The SBP,MAP,DBP and HR at 5 min after pneumperitneum,10 min after pneumperitneum and the end of operation in group I were significantly higher than those in group S（p0.05 or p0.01）.Conclusions： Sevoflurane is better than isoflurane in depressing stress responses in LC and decreasing the fluctuation of hemodynamics.

关 键 词：七氟醚 异氟醚 腹腔镜胆囊切除术 应激反应 

分 类 号：R657.4[医药卫生—外科学]