不同手术时间麻醉对子宫肌瘤剔除术后患者早期恢复的影响  

Effects of Anesthesia at Different Surgery Time on Early Postoperative Recovery in Patients Performed Myomectomy

作　　者：侯海涛 邓立琴[1] 邱玉雪[1] 武淑晶 马晶晶 HOU Haitao;DENG Liqin;QIU Yuxue;WU Shujing;MA Jingjing(Department of Anesthesiology,the General Hospital of Ningxia Medical University,Yinchuan 750004,China;Clinical College of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院麻醉科,银川750004 [2]宁夏医科大学临床医学院,银川750004

出　　处：《宁夏医科大学学报》2022年第10期1029-1033,共5页Journal of Ningxia Medical University

摘　　要：目的探讨麻醉时间对腹腔镜子宫肌瘤剔除术患者术后早期恢复的影响。方法选择全凭静脉麻醉下行腹腔镜子宫肌瘤剔除术患者62例,ASA分级Ⅰ或Ⅱ级,根据不同的麻醉开始时间分为两组(n=31):上午(8:00—12:00)全麻组(A组)和下午(14:00—18:00)全麻组(P组)。记录两组患者基本资料、手术情况、麻醉用药及术后疼痛、恶心呕吐的治疗情况。应用术后恢复质量评估量表(PQRS)分别于拔管后15 min、拔管后30 min、术后1 d、术后3 d评估两组患者术后恢复质量。比较两组患者术后不同时间点各项恢复指标及恢复率。比较两组患者围术期血浆中(ELISA法)褪黑素(MT)、皮质醇、C-反应蛋白(CRP)及快速血糖水平。结果两组患者手术相关情况、麻醉药物用量、术后疼痛及恶心呕吐管理等差异均无统计学意义(P均>0.05)。与A组相比,P组患者术后1 d认知功能评分及恢复率下降(P均<0.05),术后3 d两组患者认知功能评分及恢复率差异无统计学意义(P均>0.05)。两组患者术后各时间点生理功能、伤害性刺激、情感变化、日常生活活动能力、PQRS总分及恢复率差异无统计学意义(P均>0.05)。与A组比较,P组患者术后1 d的MT水平降低,皮质醇水平升高(P均<0.05);两组患者围术期血糖和CRP水平差异无统计学意义(P均>0.05)。结论不同手术麻醉时间对患者术后第1天认知功能恢复的影响稍有差异,但对术后早期整体恢复无明显影响。Objective To investigate the effect of anesthesia time on early postoperative recovery of patients undergoing laparoscopic myomectomy.Methods According to the start time of anesthesia,62 patients of ASA grades I-II,scheduled for laparoscopic myomectomy under total intravenous anesthesia,were divided into 2 groups(n=31):group A(8:00-12:00)and group P(14:00-18:00).The basic information,operation conditions,anesthetic dosage,postoperative pain,nausea and vomiting of the two groups were recorded.Postoperative quality of recovery scale(PQRS)was used to evaluate the recovery status at 15 min and 30 min after extubating,1 day and 3 day postoperatively.The differences of various indicators of recovery and restoration ratio of the two groups at different time points were compared.The perioperative plasma levels of melatonin(MT),cortisol and C-reactive protein(CRP)were measured by ELISA and rapid blood glucose was measured.Results There were no significant differences in operative conditions,anesthetic dosage,postoperative pain,nausea and vomiting management in the two groups(P all>0.05).Compared with group A,the score of cognitive function and recovery rate of patients in group P was decreased on 1 day after operation,and there was no significant difference between two groups on 3 day after operation(P all>0.05).At each time point after the operation,the scores and restoration ratio of physiologic function,nonciception response,emotional state,activities of daily living and overall PQRS were no significant difference between the two groups(P all>0.05).Compared with those in group A,the level of melatonin on 1 d after surgery in group P was significantly decreased,and the level of cortisol in group P was significantly increased(P all<0.05).There were no significant differences between the two groups in the levels of perioperative blood glucose and CRP(P all>0.05).Conclusion Anesthesia time had a slight difference in the recovery of cognitive function on the first postoperative day,but had no significant effect on the overa

关 键 词：近日节律 全身麻醉 子宫肌瘤剔除术 术后恢复质量 认知功能 

分 类 号：R737.33[医药卫生—肿瘤]