七氟烷复合瑞芬太尼对腹腔镜胆囊切除术患者应激、血流动力学和认知功能影响  

Effects of seven halothane combined with remifentanil on stress,hemodynamics and cognitive function in patients with laparoscopic cholecystectomy

作　　者：严明[1] 周薇[1] 李祖阁 李靖[1] Yan Ming;Zhou Wei;Li Zuge(Department of Orthopedics,the Seventh People's Hospital of Changzhou in Jiangsu Province,Changzhou 213011)

机构地区：[1]江苏省常州市第七人民医院麻醉科,常州213011

出　　处：《陕西医学杂志》2018年第9期1181-1184,共4页Shaanxi Medical Journal

基　　金：江苏省卫生科研项目(H201449)

摘　　要：目的:观察七氟烷复合瑞芬太尼在腹腔镜胆囊切除术中的应用效果,及对患者应激指标、血流动力学和认知功能的影响。方法:选取行腹腔镜胆囊切除术的患者为研究对象,所有患者麻醉诱导方法相同,根据其麻醉维持方法的不同分为七氟烷复合瑞芬太尼组(A组)和异丙酚复合瑞芬太尼组(B组)。观察两组患者应激指标、血流动力学的差异,比较两组术后认知功能的差异。结果:A组患者术后E、NE和Cor水平均低于B组,差异有统计学意义(t=-12.645、-12.165、-22.671,P<0.001);两组患者气腹前血流动力学指标无差别,气腹后和放气后,A组患者HR、MAP和SV水平波动明显较B组小(P<0.05);两组患者术后2h定向力、瞬时记忆、注意力计算力、短时记忆、语言能力、视空间觉等认知功能得分比较无统计学差异(P>0.05)。结论:七氟烷复合瑞芬太尼在腹腔镜胆囊切除术中的应用效果较好,可降低患者的应激水平,且对血流动力学指标和认知功能影响较小,具有良好的应用价值。Objective:To observe the effect of seven flurane combined remifentanil in laparoscopic cholecystectomy and its influence on stress index and hemodynamics.Methods:The patients who received laparoscopic cholecystectomy were selected as the research subjects.All patients received the same anesthesia induction method.According to their anesthesia maintenance methods,they were divided into seven flurane compound remifentanil group(A group)and propofol combined remifentanil group(B group).The defference postoperative cognitive function were compared between the two groups.Results:The levels of E,NE and Cor in group A were lower than those in group B,and the difference was statistically significant(t=-12.645,-12.165,-22.671,P<0.001).In the two groups,there was no difference in the hemodynamic indexes before pneumoperitoneum.After pneumoperitoneum and bleed,the levels of HR,MAP and SV in the A group were significantly smaller than those in the B group(P<0.05).There was no significant difference in the scores of cognitive function between the two groups after operation(P>0.05),such as 2H orientation,instantaneous memory,attention computing power,short-term memory,language ability and visual space perception..Conclusion:Sevoflurane combined with remifentanil is effective in laparoscopic cholecystectomy,it can reduce stress level of patients,and has little effect on hemodynamics and cognitive function.

关 键 词：七氟烷/治疗应用 @瑞芬太尼 镜胆囊切除术 腹腔 氧化性应激 血流动力学 认知功能障碍 

分 类 号：R614.2[医药卫生—麻醉学]