丙泊酚复合异氟醚用于妇科腹腔镜手术麻醉的应激激素及血流动力学变化  

Changes in stress hormones and hemodynamic indicators in gynecological laparoscopic surgery anesthesia induced by propofol isoflurane composite

作　　者：祁春华 胡建[2] 

机构地区：[1]湖北省宜昌市妇幼保健院麻醉科,湖北宜昌443000 [2]南京医科大学附属南京第一医院麻醉科,江苏南京210000

出　　处：《海南医学院学报》2014年第10期1411-1413,共3页Journal of Hainan Medical University

基　　金：南京市科技局资助项目(201201076)~~

摘　　要：目的:比较不同麻醉方式对妇科腹腔镜手术患者的影响。方法:选取本院收治的145例手术患者依据麻醉方式差异分组,其中对照组72例行瑞芬太尼丙泊酚全凭静脉麻醉,观察组73例行丙泊酚复合异氟醚麻醉,对比两组麻醉效果。结果:观察组T2、T3时段收缩压(SBP)、舒张压(DBP)与心率(HR)明显低于T0和T1时段,差异具有统计学意义(P<0.05);诱导后两组血压与心率各项指标均明显降低,差异具有统计学意义(P<0.05);插管即刻与插管后去甲肾上腺素(NE)、肾上腺素(E)、血浆皮质醇(cort)与血管紧张素Ⅱ(ATⅡ)水平均明显提升,且观察组水平上升相对较少,差异具有统计学意义(P<0.05);观察组气腹后气道压力(Paw)、动脉血氧饱和度(SaO2)与呼气末二氧化碳分压(PETCO2)变化更为明显,放气后两组均逐渐恢复正常。结论:丙泊酚复合异氟醚麻醉可有效控制术者麻醉后的应激反应,且该种麻醉手段更利于保持术者血流动力学的稳定。Objective：To compare the influence of different anesthesia method on patients undergoing gynecological laparoscopic surgery.Methods：A total of 145 patients scheduled for surgery were divided into observation group and control group on the basis of anesthesia method.72 cases in the control group were given routine intravenous fentanyl propofol for anesthesia,73 cases in the observation group were given propofol compound isoflurane to induce anesthesia.Anesthesia effects were compared between the two groups.Results：Systolic blood pressure（SBP）,diastolic blood pressure（DBP）and heart rate（HR）of the observation group at T2 and T3were significantly lower than that at T0 and T1（P〈0.05）.After anesthesia induction,blood pressure and heart rates in both groups were significantly decreased（P〈0.05）.At time of intubation insertion and after intubation,NE,E,cort,ATⅡ levels were significantly increased in both group,but the increase was slighter in the observation group（P〈0.05）.After preparation of pneumoperitoneum,changes in Paw,SaO2,and PETCO2 were more obvious in the observation group.Conclusion：Propofol combined with isoflurane for anesthesia can effectively control stress reaction and keep hemodynamics stable.

关 键 词：丙泊酚 异氟醚 腹腔镜应激激素 血流动力学 

分 类 号：R614[医药卫生—麻醉学]