腹腔镜胆囊切除术不同麻醉方法对老年人应激反应的影响探析  

Analysis of shock response effect of laparoscopic cholecystectomy of different anesthesia methods for the elderly

作　　者：李素珍[1] 冯作炫[2] 

机构地区：[1]河南省濮阳市人民医院麻醉科,河南濮阳457000 [2]福建省宁德市医院麻醉科,福建宁德352100

出　　处：《中国当代医药》2013年第10期95-96,共2页China Modern Medicine

基　　金：福建省卫生厅青年基金项目课题(2007-2-43)

摘　　要：目的探讨腹腔镜胆囊切除术不同麻醉方法对老年人应激反应的影响。方法本次研究选择的对象共80例,均为本院2011年7月～2012年7月收治行腹腔镜胆囊切除术的老年患者,随机分为七氟烷组(七氟烷静吸复合麻醉)和丙泊酚组(丙泊酚全凭麻醉)各40例,回顾两组临床资料。结果两组与T0比较,HR水平在T1时均下降,差异有统计学意义(P<0.05);七氟烷组T2下降与T0比较差异有统计学意义(P<0.05),丙泊酚组差异无统计学意义(P>0.05)。与T0比较,丙泊酚组SBP和DBP在T1和T2时点差异无统计学意义(P>0.05);七氟烷组SBP在T1和T2均下降,在T2,DBP下降,差异均有统计学意义(P<0.05)。T1时点两组血糖均升高,但在正常范围,T1与T2时点丙泊酚组差异有统计学意义(P<0.05),两组T2时点较T0时点下降但无差异。两组各时间点皮质醇比较差异均有统计学意义(P<0.05)。七氟烷组T2时点与T0时点比较差异有统计学意义(P<0.05)。结论老年人腹腔镜胆囊切除术中,七氟烷和丙泊酚对患者血流动力学的影响程度相差不明显,但七氟烷可更好地对老年患者交感神经兴奋进行抑制,降低机体的应激反应,更具安全性。Objective To investigate the effect of laparoscopic cholecystectomy of different anesthesia methods on stress reaction in old patients. Methods Eighty cases performed laparoscopic cholecystectomy in elderly patients in our hospital from July 2011 to July 2012 were selected, and randomly divided into sevoflurane group （sevoflurane anesthe- sia） and propofol group （propofol on anesthesia） with 40 cases in each, the clinical data of two groups were reviewed. Results The comparison of two group at T0, HR levels were reduced in T1, the difference was significant （P 〈 0.05）; T2 compared with T0, sevoflurane group decreased significantly （P 〈 0.05）, propofol group had no significant difference （P 〉 0.05）. Compared with T0, SBP and DBP of propofol group had no difference in T1 and T2 point （P 〉 0.05）; SBP of sevoflurane group decreased at T1 and T2, at T2, DBP decreased, with significant difference （P 〈 0.05）. At T1, blood sugar of two groups were increased, but in the normal range, there was significant difference between the TI and T2 in propofol group （P 〈 0.05）, two groups of T2 point decreased more than To point, but had no difference. Two groups of each time point, there was significant difference in cortisol （P 〈 0.05）. There was significant difference between the sevoflurane group at T2 point and To point （P 〈 0.05）. Conclusion Laparoscopic cholecystectomy in the elderly, the in- fluence degrees of sevoflurane and propofol on hemodynamics in patients is not obvious, but the sevoflurane can bet- terly restrain in elderly patients with sympathetic excitement, reduce the stress reaction of the body, be more safety

关 键 词：腹腔镜 胆囊切除术 七氟烷 丙泊酚 老年人 应激反应 

分 类 号：R614[医药卫生—麻醉学]