子宫肌瘤腹腔镜手术中行依托咪酯靶控输注联合纳布啡麻醉效果及对患者PGE_(2)、VEGF-C水平影响  

Effect of etomidate target controlled infusion combined with naborphine anesthesia during laparoscopic hysteromyoma and its effects on prostaglandin E_(2) and vascular endothelial growth factor-C

作　　者：黄艳华[1] 资瑜 HUANG Yanhua;ZI Yu(Affiliated Hospital of Xiangnan University,Chenzhou,Hunan Province,423099;Clinical College of Xiangnan University)

机构地区：[1]湘南学院附属医院,郴州423099 [2]湘南学院临床学院

出　　处：《中国计划生育学杂志》2022年第5期1070-1074,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨子宫肌瘤腹腔镜手术中行依托咪酯靶控输注联合纳布啡的麻醉效果及对患者前列腺素E_(2)(PGE_(2))和血管内皮生长因子-C(VEGF-C)水平影响。方法:选取2020年3月-2021年3月本院收治的行腹腔镜下子宫肌瘤剔除术治疗患者102例,根据麻醉方法不同分为瑞芬太尼组(依托咪酯靶控输注联合瑞芬太尼麻醉)和纳布啡组(依托咪酯靶控输注联合纳布啡麻醉)各51例,比较两组疗效、手术情况、流动力学指标、PGE_(2)和VEGF-C水平变化及不良反应。结果:治疗后临床优良率纳布啡组(92.2%)高于瑞芬太尼组(76.5%),手术时间纳布啡组(13.6±9.5min)短于瑞芬太尼组(17.5±4.0min),麻醉后10 min、30min及术后10min的流动力学指标水平瑞芬太尼组较麻醉前10min下降且低于纳布啡组(均P<0.05),而纳布啡组较麻醉前10min无差异(P>0.05)。麻醉2h后两组PGE_(2)、VEGF-C水平均低于麻醉前,且纳布啡组(212.39±13.51 pg/ml、233.46±19.58 pg/ml)低于瑞芬太尼组(253.13±19.39 pg/ml、276.39±25.37 pg/ml)(P<0.05)。不良反应发生率纳布啡组(11.8%)低于瑞芬太尼组(29.4%)(P<0.05)。结论:子宫肌瘤腹腔镜手术中行依托咪酯靶控输注联合纳布啡麻醉,能缩短手术时间,患者血流动力学总体更平稳,降低术后PGE_(2)、VEGF-C水平,不良反应更低,麻醉效果更佳。Objective: To investigate the effect of etomidate target controlled infusion combined with naborphine anesthesia during laparoscopic surgery of hysteromyoma of the patients, and to study its effects on the levels of the prostaglandin E_(2)(PGE_(2)) and vascular endothelial growth factor-C(VEGF-C) of the patients. Methods: 102 patients with hysteromyoma who wanted laparoscopic myomectomy were selected and were divided into group A(51 patients were given etomidate target controlled infusion combined with remifentanil anesthesia) and group B(51 patients were given etomidate target controlled infusion combined with naborphine anesthesia) according to different anesthesia methods from March 2020 to March 2021. The curative effects, the operation situation, the levels changes of hemodynamic indexes, PGE;, and VEGF-C, and the rate of adverse reactions of the patients were compared between the two groups. Results: After treatment, the clinical excellence rate(92.2%) of the patients in group B was significantly higher than that(76.5%) of the patients in group A, and the operative time(13.6±9.5 min) of the patients in group B was significantly shorter than that(17.5±4.0 min) of the patients in group A. The levels of haemodynamics indexes of the patients in group A at 10 min, 30 min, and 10 min after anesthesia were significantly lower than those before anesthesia, and were also significantly lower than those of the patients in group B at 10 min, 30 min, and 10 min after anesthesia(all P<0.05), while which had no significant different from those of the patients in group B at 10 min before anesthesia(P>0.05). The levels of PGE_(2) and VEGF-C(212.39±13.51 pg/ml and 233.46±19.58 pg/ml) of the patients in group B were significantly lower than those(253.13±19.39pg/ml and 276.39±25.37pg/ml)of the patients in group A(P<0.05).The incidence of the adverse reactions(11.8%)of the patients in group B was significantly lower than that(29.4%)of the patients in group A(P<0.05).Conclusion:Etomidate target-controlled infusion combined

关 键 词：子宫肌瘤腹腔镜手术 依托咪酯 纳布啡 瑞芬太尼 前列腺素E_(2) 血管内皮生长因子-C 麻醉效果 手术指标 

分 类 号：R614[医药卫生—麻醉学] R737.33[医药卫生—外科学]