丙泊酚复合异氟烷麻醉对妇科腹腔镜手术患者应激激素及血流动力学变化的回顾性分析  

Retrospective Analysis on Effects of Propofol Isoflurane Composite Anesthesia on Stress Hormones and Hemodynamic Changes in Patients with Gynecological Laparoscopic Surgery

作　　者：章国芬[1] 余静[1] 郭丽英[1] 

机构地区：[1]浙江萧山医院麻醉科,杭州311202

出　　处：《中国药师》2015年第1期85-87,共3页China Pharmacist

摘　　要：目的:比较不同麻醉方式对妇科腹腔镜手术患者应激激素及血流动力学变化的影响。方法:采用回顾性分析方法,145例妇科腹腔镜手术患者按麻醉方式不同分为两组。对照组72例采用瑞芬太尼丙泊酚静脉麻醉,观察组73例采用丙泊酚复合异氟烷麻醉,对比两组患者不同时点收缩压(SBP)、舒张压(DBP)、心率(HR)等血流动力学指标,以及血浆去甲肾上腺素(NE)、肾上腺素(E)、血浆皮质醇(cort)与血管紧张素Ⅱ(ATⅡ)等应激激素水平变化。同时观察两组药品不良反应发生情况。结果:T2、T3时点两组SBP、DBP与HR均显著低于T0时点(P<0.05),且观察组SBP和HR低于同时点对照组(P<0.05)。T2、T3时点两组NE、E、cort、ATⅡ水平均较T0时点明显上升(P<0.05),且观察组上升幅度低于对照组(P<0.05)。观察组呼吸抑制、低血压、心动过缓等不良反应发生率以及不良反应总发生率均明显低于对照组(P<0.05)。结论:丙泊酚复合异氟烷麻醉较之丙泊酚瑞芬太尼复合静脉麻醉,更有利于保持患者血流动力学的稳定,降低应激反应,且不良反应少,安全性高,值得临床推广使用。Objective： To compare the effects of different anesthesia methods on stress hormones and hemodynamic changes in the patients with gynecological laparoseopic surgery. Methods： Retrospective analysis was carried out. Totally 145 patients with gynecolog- ical laparoscopie surgery were divided into two groups according to the anesthesia method, the control group with 72 cases was given routine remifentanyl propofol intravenous anesthesia, and the observation group with 73 cases was given routine propofol isoflurane com- posite anesthesia. Such hemodynamic indices as SBP, DBP and HR, and plasma NE, E, cort and AT II levels at different time points in the two groups were studied and compared, and adverse drug reactions were also observed in the two groups. Results： The BP and HR at T2 and T3 time point in the two groups were sign/ficantly lower than those at TO time point （P 〈 0.05）, and those in the obser- vation group were lower than those in the control group at the same time point（P 〈0.05）. The levels of NE, E, cort and AT Ⅱ at T2 and T3 time point in the two groups were significantly higher than those at TO time point （ P 〈 0.05 ） , while the increase in the observa- tion group was lower than that in the control group （P 〈 0.05）. The incidence of adverse drug reactions （ADR）, such as respiratory depression, hypertension, bradycardia and so on, and the total incidence of ADR in the observation group were both lower than those in the control group （ P 〈 0.05 ）. Conclusion ： Compared with remifentanyl propofol intravenous anesthesia, propofol isoflurane composite anesthesia can keep the hemodynamic stability more effectively and reduce the stress reaction with fewer ADR and promising safety, which is worthy of wider application in clinics.

关 键 词：丙泊酚 异氟烷 瑞芬太尼 腹腔镜 应激激素 血流动力学 

分 类 号：R971.2[医药卫生—药品]