两种不同浓度的七氟醚复合丙泊酚静-吸复合麻醉对肝脏部分切除术患者术后苏醒质量的影响  

Effect of two different concentrations of sevoflurane and propofol intravenous-inhalation compound anesthesia on postoperative revival quality of patients with partial hepatectomy

作　　者：朱东阳[1] 周国斌[1,2] 黄静[1] 刘作坤[1] ZHU Dong-yang;ZHOU Guo-bin;HUANG Jing(Department of Anesthesia, Shenzhen City Longgang District People’s Hospital,Shenzhen 518172, China)

机构地区：[1]深圳市龙岗区人民医院麻醉科,518172 [2]广东省人民医院麻醉科

出　　处：《中国现代药物应用》2017年第3期14-16,共3页Chinese Journal of Modern Drug Application

摘　　要：目的对行肝脏部分切除术的患者采用不同浓度的七氟醚复合丙泊酚静-吸复合麻醉,观察术后苏醒情况,探索不同浓度的麻醉对于患者苏醒质量的影响。方法 122例行肝脏部分切除术的患者,按照随机法分为A组和B组,每组61例。A组患者的麻醉方法为:0.5 MAC七氟醚复合丙泊酚静-吸复合麻醉;B组患者的麻醉方法为:1.0 MAC七氟醚复合丙泊酚静-吸复合麻醉。观察两组的麻醉效果。结果 A组拔管后即刻(T1)、拔管后5 min(T2)时的警觉/镇静评分(OAA/S)低于B组,差异具有统计学意义(P<0.05);两组拔管后15 min(T3)、拔管后30 min(T4)时的OAA/S评分比较差异无统计学意义(P>0.05)。A组T1时的Aldrete评分低于B组,差异具有统计学意义(P<0.05);两组T2、T3、T4时的Aldrete评分比较差异无统计学意义(P>0.05)。A组患者的并发症发生率6.56%低于B组的19.67%,差异具有统计学意义(P<0.05)。结论在肝脏部分切除术的麻醉中,高浓度的七氟醚复合丙泊酚静-吸复合麻醉苏醒后的苏醒质量较好,但是并发症发生率较高,临床上应结合患者的实际情况合理确定七氟醚的浓度,提高患者术后苏醒质量。Objective Partial hepatectomy patients received different concentrations of sevoflurane and propofol intravenous-inhalation compound anesthesia, and their postoperative revival situation are observed to explore effect of different concentrations of anesthesia on revival quality. Methods A total of 122 partial hepatectomy patients were randomly divided into group A and group B, with 61 cases in each group. Group A received 0.5 MAC sevoflurane and propofol intravenous-inhalation compound anesthesia, and group received 1.0 MAC sevoflurane and propofol intravenous-inhalation compound anesthesia. Anesthetic effect was compared in two groups. Results Group A had lower observer’s assessment of alertness/sedation scale (OAA/S) at immediate extubation (T1) and 5 min after extubation (T2) than group B, and their differences had statistical significance (P<0.05). There were no statistically significant difference in OAA/S score at 15 min after extubation (T3) and 30 minafter extubation (T4) in two groups (P>0.05). Group A had lower Aldrete score at T1 than group B, and thedifference had statistical significance (P<0.05). There were no statistically significant difference in Aldrete scoreat T2, T3 and T4 in two groups (P>0.05). Group A had incidence of complications as 6.56%, which was lower than19.67% in group B, and the difference had statistical significance (P<0.05). Conclusion For anesthesia in partial hepatectomy, anesthesia with high concentrations of sevoflurane and propofol intravenous-inhalation provides better recovery quality, but with higher incidence of complications. It should be combined with the actual situation of patients to reasonably determine the concentration of sevoflurane in clinic, in order to improve their recovery quality.

关 键 词：七氟醚 丙泊酚 静-吸复合麻醉 肝脏部分切除术 苏醒 

分 类 号：R614.27[医药卫生—麻醉学]