丙泊酚与七氟烷配合右美托咪定对老年腹腔镜下肿瘤切除患者血流动力学的影响  

Effect of propofol and sevoflurane combined with dexmedetomidine on hemodynamics in elderly patients undergoing laparoscopic tumor resection

作　　者：张莉[1] 王义[1] 王莉[1] 黄蓉 仇丽雅 ZHANG Li;WANG Yi;WANG Li(Department of Anesthesiology,the First People′s Hospital of Guangyuan,Guangyuan 628017,Sichuan,China)

机构地区：[1]广元市第一人民医院麻醉科

出　　处：《中国老年学杂志》2019年第16期3969-3972,共4页Chinese Journal of Gerontology

基　　金：广元市科技局基金资助项目(17ZDYF0006)

摘　　要：目的对比分析丙泊酚与七氟烷配合右美托咪定对老年腹腔镜下肿瘤切除患者血流动力学的影响。方法老年腹腔镜下肿瘤切除手术患者94例,按照随机数字表法分为对照组47例与观察组47例。观察组采用丙泊酚配合右美托咪定麻醉,对照组采用七氟烷配合右美托咪定麻醉。比较两组手术时间、出血量和麻醉时间,术前、术后3 h和术后6 h简易精神状态评价量表(MMSE)评分,不同时刻血流动力学指标变化。结果两组手术时间、出血量和麻醉时间比较无统计学差异(P>0.05)。两组术后3 h MMSE评分较术前明显降低(P<0.05);观察组术后6 h MMSE评分与术前比较无明显变化(P>0.05),而对照组术后6 h MMSE评分较术前仍明显降低(P<0.05);观察组术后3 h和术后6 h MMSE评分明显高于对照组(P<0.05)。两组麻醉诱导后(T1)舒张压(DBP)和收缩压(SBP)较麻醉诱导前(T0)明显降低,而平均动脉压(MAP)较T0时刻明显升高(P<0.05);观察组T1、插管时(T2)和拔管后(T3)DBP和SBP明显高于对照组,而MAP明显低于对照组(P<0.05)。结论丙泊酚配合右美托咪定对老年腹腔镜下肿瘤切除手术患者血流动力学影响小,且对术后认知功能影响小。Objective To compare the effects of propofol and sevoflurane combined with dexmedetomidine on hemodynamics in elderly patients undergoing laparoscopic tumor resection.Methods The 94 cases of elderly patients undergoing laparoscopic tumor resection were randomly divided into control group(47 cases)and observation group(47 cases).Group A was treated with propofol combined with dexmedetomidine and group B with sevoflurane combined with dexmedetomidine anesthesia.The operation time,bleeding volume and anesthesia time,MMSE score before operation,3 hours after operation and 6 hours after operation,and hemodynamic changes at different times were compared between the two groups.Results There was no significant difference in operative time,bleeding volume and anesthetic time between the two groups(P>0.05).The MMSE score of group A was lower than that of group B at 3 h after operation(P<0.05),and the MMSE score of group A was higher than that of group B at 6 h after operation(P<0.05).HR,DBP and SBP were lower at T1,but MAP was higher at T1,T2 and T3 than those at T0(P<0.05),DBP and SBP were higher in group A than those in group B,but MAP was lower in group B(P<0.05).Conclusions Propofol combined with dexmedetomidine has little effect on hemodynamics and postoperative cognitive function in elderly patients undergoing laparoscopic tumor resection.

关 键 词：丙泊酚 七氟烷 右美托咪定 腹腔镜肿瘤切除术 血流动力学 

分 类 号：R614[医药卫生—麻醉学]