不同麻醉药物对腹腔镜胆囊切除术应激反应的影响  

Effects of Different Anesthesia Drug on Response in Patients Receiving Laparoscopic Cholecystectomy

作　　者：鲁鸿[1] 刘桃[2] 李秀泽[1] 孙德友[1] 李卫[1] 

机构地区：[1]绵阳市中心医院麻醉科,绵阳621000 [2]绵阳市人民医院麻醉科,绵阳621000

出　　处：《中国医药导刊》2013年第4期672-673,675,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:比较丙泊酚复合瑞芬太尼与七氟醚复合笑气吸入两种麻醉药物使用方法对腹腔镜胆囊切除术应激反应的影响。方法:选取2011.1～2012.1在本院进行腹腔镜胆囊手术的50例病人。其中男31例,女29例,随即分为丙泊酚复合瑞芬太尼靶控输注静脉组(A组)和异氟醚复合笑气吸入麻醉组(B组),每组25例。比较术中患者各时点的MAP、HR、SpO2、PETCO2等相关指标变化情况和术后不良反应情况。结果:A组平均动脉压高于B组(P<0.05)。两组患者心率均低于麻醉前数值,A组诱导后10min心率下降,低于吸入麻醉组(P<0.05)。A组麻醉后不良反应发生率明显低于B组(P<0.05)。结论:两种不同的麻醉药物组合方式均能维持腹腔镜胆囊手术中患者的血流动力学稳定,丙泊酚复合瑞芬太尼靶控麻醉效果更持久,不良反应更低。本研究为临床医生选择合适的麻醉方法提供了一定的参考依据。Objective：To evaluate the efficacy and side effect of target controlled infusion of sevoflurane and propofol on patients with laparoscopic cholecystectomy. Methods： 50 patients （ASAⅠ~Ⅱ） underwent laparoscopic cholecystectomy were randomized into propofol group（Group A, n=25） and sevoflurane group（ Group B, n=20）. The MAP, H R, SpO2 and PETCO2 were recorded before anesthesia induction and 5, 10, 15, 20min after tracheal intubation respectively. Recovery time and side effects were recorded during emergency period. Results：A group of mean arterial pressure than in group B （P〈0.05）. The two groups of patients with heart rate were lower than the pre-anesthetic value 10min after the A group induced heart rate decreased, lower than inhaled anesthesia group （P〈0.05）. The incidence of adverse reactions in the group A, anesthesia was significantly lower than that in group B （P〈0.05）. Conclusion：TCI propofol is easier to maintain stable hemodynamics than TCI sevoflurane, but the recovery time may be prolonged during emergency period. It must be selected reasonably according to the clinical situation.

关 键 词：麻醉药物 腹腔镜胆囊手术 应激反应 

分 类 号：R614[医药卫生—麻醉学] R657.4[医药卫生—外科学]