丙泊酚复合瑞芬太尼对腹腔镜胆囊切除术高血压病患者胰岛素抵抗和应激反应的影响  

作　　者：陆荣臻[1] 黄泽汉[1] 李天资[2] 黄锦益[1] 韦忠良[1] 李近都[3] 

机构地区：[1]右江民族医学院附属医院麻醉科,广西百色533000 [2]右江民族医学院附属医院心研所,广西百色533000 [3]广西医科大学在读研究生,广西南宁530021

出　　处：《检验医学》2016年第B09期276-277,共2页Laboratory Medicine

摘　　要：目的分析了丙泊酚复合瑞芬太尼对腹腔镜胆囊切除术高血压病患者胰岛素抵抗和应激反应的影响。方法选取2013年4月至2016年4月来我院就诊的需进行腹腔镜胆囊切除术的高血压病患者120例，男78例，女42例，随机分为研究组与对照组，每组各60例，对照组通过异氟醚复合芬太尼进行麻醉，研究组通过丙泊酚复合瑞芬太尼进行麻醉，对两组患者肌肉松弛及麻醉效果进行观察，并测定两组患者术前术后血清hs—CRP及胰岛素抵抗指数。结果两组患者肌肉松弛及麻醉效果均非常满意。两组患者经过腹腔镜胆囊切除术后血清hs—CRP及胰岛素抵抗指数均出现明显升高，且对照组比研究组升高幅度更大（P〈0．05）。结论丙泊酚复合瑞芬太尼对腹腔镜胆囊切除术高血压病患者胰岛素抵抗和应激反应影响较小。Objective To analyze the propofol combined with remifentanil in peritoneoscope gallbladder excision in patients with hypertensive disease patients with insulin resistance and stress response. Methods a total of 2013 April 2016 years 4 months to our hospital for treatment of laparoscopic choleeystectomy surgery in hypertensive patients with 120 cases, 78 cases were male, female 42 cases randomly divided into study group and control group, each with 60 cases in each, while those in the control group were anesthetized with isoflurane and fentanyl, study group by propofol and remlfentanil anesthesia, of two groups of patients with muscle relaxation and the effects of anesthesia were observed, and the determination of two groups of patients with preoperative postoperative serum hs CRP and insulin resistance index. Results two groups of patients with muscle relaxation and the effect of anesthesia was satisfactory. Two groups of patients after laparoscopic cholecystectomy and postoperative serum hs CRP and insulin resistance index were significantly increased and in the control group than the study group were significantly greater （P 〈0.05）. Conclusion propofol and remifentanil in peritoneoscope gallbladder excision in patients with hypertensive disease patients with insulin resistance and stress response is less affected.

关 键 词：丙泊酚 瑞芬太尼 腹腔镜胆囊切除术 高血压 

分 类 号：R614[医药卫生—麻醉学]