瑞芬太尼联合丙泊酚静脉麻醉对甲状腺手术血流动力学和应激反应的影响  

The Effects of Remifentanil Combined with Propofol Intravenous Anesthesia on Hemodynamics and Stress Response in Thyroid Surgery

作　　者：陆建军[1] 

机构地区：[1]东南大学医学院附属江阴医院麻醉科,江苏江阴214400

出　　处：《湖北民族学院学报（医学版）》2017年第2期29-31,共3页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的探讨瑞芬太尼联合丙泊酚静脉麻醉对甲状腺手术血流动力学和应激反应的影响。方法 64例择期行甲状腺手术患者依照随机数字表法分为瑞芬太尼联合丙泊酚全麻组(实验组)和瑞芬太尼联合七氟烷组(对照组),每组各32例,实验组行气管插管后瑞芬太尼联合丙泊酚静脉维持麻醉,对照组行瑞芬太尼联合七氟烷维持麻醉,观察两组手术开始前(T0)、手术开始后(T1)以及甲状腺分离时(T2)皮质醇、血糖和C-反应蛋白(CRP)水平,比较3个时点的平均动脉压(MAP)和心率值(HR)。结果与T0时点比较,T1、T2时点两组皮质醇、血糖和CRP水平均明显升高(P<0.05);T1、T2时点实验组皮质醇、血糖和CRP水平均明显低于对照组(P<0.05);两组MAP和HR比较均无统计学差异(P>0.05)。结论瑞芬太尼联合丙泊酚进行术中麻醉维持对甲状腺手术患者能较好地保持血流动力学的稳定,更好地抑制机体应激反应。Objective to study the effects of Remifentanil combined with Propofol intravenous anesthesia on hemodynamics and stress response in thyroid surgery. Methods 64 patients with thyroid surgery were randomly divided into Remifentanil combined with Propofol anesthesia group （Experimental Group） and Propofol combined with Nitrous Oxide group （Control Group） ,32 cases in each group. The Experimental Group received the Remifentanil intravenous anesthesia after tracheal intubation and the Control Group received the inhalation anesthesia after 50% -70% nitrous oxide. The two groups were injected a small amount of Propofol. The cortisol, blood glucose and cortisol C- reactive protein （CRP） were observed before surgery （TO）, after the beginning of surgery （T1） and thyroid separation （T2）. The average arterial pressure （MAP） and heart rate （HR） were compared at T0, T1 and T2. Results Compared with TO,the cortisol, blood glucose and cortisol C- reactive protein （CRP） in the two groups at T1 and -I-2 were significantly higher（P 〈0.05）. The cortisol, blood glucose and cortisol C- reactive protein （CRP） in the Experimental Group at T1 and T2 were significantly lower than those in the Control Group （P 〈0.05）. The average arterial pressure （MAP） and heart rate （HR） in the two groups had no statistical difference （P 〉0.05）. Conclusion The Remifentanil combined with Propofol anesthesia in thyroid surgery can maintain the stability of hemodynamics and inhibit the stress response.

关 键 词：丙泊酚 静脉麻醉 平均动脉压 皮质醇 

分 类 号：R614[医药卫生—麻醉学]