腹腔镜手术患者异丙酚麻醉对应激因子和血流动力学的影响研究  

Impact of Propofol in Stress Factors and Hemodynamic Index during Laparoscopic Surgery

作　　者：范玲玲[1] 都义日[1] FAN Ling-ling;DU Yi-ri(Anesthesiology Department of The Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China)

机构地区：[1]内蒙古医科大学附属医院麻醉科,呼和浩特010050

出　　处：《循证医学》2018年第2期96-98,105,共4页The Journal of Evidence-Based Medicine

基　　金：内蒙古自治区自然科学基金资助项目(2017MS0832)

摘　　要：目的 探讨腹腔镜手术患者异丙酚麻醉对应激因子和血流动力学的影响。方法 以2013年1月至2016年5月12日在本院行腹腔镜手术的100例患者为研究对象。将100例患者按照随机数字法分为观察组(异丙酚组)和对照组(异氟醚组)各50例。取麻醉前(T_1)、气腹前(T_2)、气腹后15min(T_3)和解除气腹后15min(T_4)四个时点,分析比较手术过程中两组患者的血流动力学指标:心率、血氧饱和度、平均动脉压以及血浆中血栓素B_2和6-酮-前列腺素F1_α含量。结果 观察组患者在不同时点平均动脉压和心率未见显著性差异(P>0.05);对照组平均动脉压和心率在T_2时点开始出现波动(P<0.05);两组的血氧饱和度在手术过程中未见显著性差异(P>0.05)。两组患者在T_1和T_2时点血浆血栓素B_2和6-酮-前列腺素F1_α含量差异无显著性(P>0.05);对照组在T_3、T_4时点血浆血栓素B_2显著下降(P<0.05),6-酮-前列腺素F1_α含量明显升高(P<0.05);因此在手术过程中血栓素B_2/6-酮-前列腺素F1_α显著升高(P<0.05),而观察组血栓素B_2/6-酮-前列腺素F1_α未见显著性差异(P>0.05)。结论 腹腔镜手术中采用异丙酚进行麻醉可避免血浆血栓素B_2和6-酮-前列腺素F1_α失调,维持机体的血流动力学平稳。Objective To study the impact of Propofol in stress factors and hemodynamie index during laparoseopie surgery. Method 100 patients had perfomled the laparoseopie surgery fl＇om January 2013 to May 12, 2016 in our hospital were selected. The subjects were randomly divided into obsmwation group （Propofol） and control group （Isoflurane） , 50 eases each group. Established 4 time points as follow： before anesthesia （T,） , before pneumoperitoneunl （%） , after 15 min of pneumoperitoneunl （T3） and after 15 min of eliminating pneumoperitoneum （%）. The index of HR （heart rate） , Sp02 （surplus pulse 02） and MAP （mean arterial pressure） as well as the content of TXB2 （thromboxane B2） and 6-keto-PGF1α （6-keto-prostaglandin-F1α） were obsmwed. Result At each time period, the index of MAP and HR for obsmwation group was not significantly different （P〉0.05） ; since %, the index of MAP and HR for control group was changed （P〈0.05） ; during surgery, the index of Sp02 for two groups was not significantly different （P〉0.05） ; at T, and %, the content of TXB2 and 6-keto-PGF1α for two groups was not significantly different （P〉 0.05） ; at T3 and %, the content of TXB2 for control group was reduced （P〈0.05） ; the content of 6-keto-PGF1α was increased （P〈0.05） ; during surgery, the index of TXBJ6-keto-PGF1α was increased （P〈0.05） ; the index of TXBJ6- keto- PGF1α for obsmwation group was not significantly different （P〉0.05）. Conclusion During the laparoseopie surgery, Propofol can avoid the imbalance of TXB2 and 6-keto-PGF1α and maintain the hemodynamie stability.

关 键 词：腹腔镜 异丙酚 内环境 自控镇痛 

分 类 号：R971.2[医药卫生—药品]