七氟醚预防垂体后叶素诱发心血管不良反应的效果研究  

Effect of Sevoflurane on vasopressin-induced cardiovascular adverse reactions

作　　者：陈蒙蒙[1] 徐芳[1] 陈贤梅[2] 邓智连[1] Meng-meng Chen;Fang Xu;Xian-mei Chen;Zhi-lian Deng(Department of Anesthesiology,Jiangxi Maternal and Child Health Hospital Nanchang,Jiangxi 330006,China;Operation Room,Jiangxi Maternal and Child Health Hospital Nanchang,Jiangxi 330006,China)

机构地区：[1]江西省妇幼保健院麻醉科,江西南昌330006 [2]江西省妇幼保健院手术室,江西南昌330006

出　　处：《中国现代医学杂志》2018年第29期74-78,共5页China Journal of Modern Medicine

基　　金：江西省卫生计生委科技计划(No:20185428)

摘　　要：目的探讨七氟醚预防垂体后叶素诱发心血管不良反应的效果。方法选取该院2017年1月-2017年5月收治的子宫平滑肌瘤患者60例,使用随机数字表法分为七氟醚组和全凭静脉麻醉(TIVA)组,每组30例。两组患者行腹腔镜下肌瘤剔除术,七氟醚组吸入七氟醚并用瑞芬太尼静脉泵入维持;TIVA组以异丙酚和瑞芬太尼静脉泵入维持,记录两组患者子宫肌内注射垂体后叶素前(T_0),以及注射后0.5(T_1)、1.0(T_2)、2.0(T_3)、3.0(T_4)、5.0(T_5)、10.0(T_6)、20.0(T_7)和30.0 min(T_8)的心率(HR)、收缩压(SBP)、舒张压(DBP)、血氧饱和度、呼气末二氧化碳、皮质醇水平;比较两组患者苏醒时间和出血量。结果七氟醚组患者T_1时的HR高于T_0(P<0.05)。TIVA组患者T_5、T_6、T_7、T_8时的HR低于T_0(P<0.05),SBP、DBP高于T_0(P<0.05)。七氟醚组T_8时的HR低于T_0(P<0.05),但高于TIVA组(P<0.05)。七氟醚组T_1时的SBP、DBP低于T_0(P<0.05),T_7、T_8时的SBP、DBP高于T_0(P<0.05)。七氟醚组T_8时的SBP、DBP低于TIVA组(P<0.05)。两组患者T_3、T_4、T_5、T_6、T_7、T_8时的皮质醇水平高于T_0(P<0.05)。七氟醚组T_5、T_6、T_7、T_8时的皮质醇水平低于TIVA组(P<0.05)。七氟醚组患者苏醒时间短于TIVA组(P<0.05)。七氟醚组患者出血量少于TIVA组(P<0.05)。结论七氟醚能有效预防垂体后叶素诱发的心血管不良反应。与TIVA比较,七氟醚能减小血压升高幅度,减轻应激反应,缩短苏醒时间,减少出血量,值得临床推广应用。Objective To investigate the effect of Sevoflurane in preventing vasopressin-induced cardiovascular adverse reactions.Methods Sixty patients with uterine leiomyoma admitted in our hospital from January 2017 to May 2017 were randomly divided into a Sevoflurane group and a total intravenous anesthesia(TIVA)group,with 30 cases in each group.The two groups of patients underwent laparoscopic myomectomy;the patients in the Sevoflurane group had Sevoflurane inhalation and Remifentanil intravenous maintenance,the patients in the TIVA group received intravenous anesthesia with Propofol and Remifentanil intravenous maintenance.Heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),oxygen saturation,end-tidal carbon dioxide and cortisol level were measured in both groups before pituitrin injection into uterine muscle(T0),and 0.5(T1),1(T2),2(T3),3(T4),5(T5),10(T6),20(T7)and 30 min(T8)after pituitrin injection.The recovery time and blood loss were compared between the two groups.Results In the Sevoflurane group HR at T1 was higher than that at T0(P<0.05).In the TIVA group HR at T5-T8 was lower than that at T0(P<0.05),while SBP and DBP at T5-T8 were higher than those at T0(P<0.05).HR of the Sevoflurane group at T8 was lower than that at T0(P<0.05)but higher than that of the TIVA group(P<0.05).In the Sevoflurane group,SBP and DBP at T1 were lower than those at T0(P<0.05),while SBP and DBP at T7 and T8 were higher than those at T0(P<0.05).At T8,SBP and DBP in the Sevoflurane group were lower than those in the TIVA group(P<0.05).In both groups the cortisol level at T3-T8 was higher than that T0.The serum cortisol level at T5-T8 in the Sevoflurane group was lower than that in the TIVA group(P<0.05).The recovery time of the patients in the Sevoflurane group was significantly shorter than that in the TIVA group(P<0.05).The amount of bleeding in the Sevoflurane group was significantly less than that in the TIVA group(P<0.05).Conclusions Sevoflurane can effectively prevent vasopressin-induced cardiovascular adverse

关 键 词：七氟醚 垂体后叶素 心血管 不良反应 应激 

分 类 号：R614[医药卫生—麻醉学]