瑞芬太尼、丙泊酚复合异氟醚麻醉对腹腔镜全子宫切除术患者炎性因子及血流动力学的影响  

Effects of remifentanil,propofol combined with isoflurane on inflammatory factors and hemodynamics in patients undergoing laparoscopic total hysterectomy

作　　者：李静[1] 王伟[1] 石军 LI Jing;WANG Wei;SHI Jun(Department of Anesthesiology,the first Affiliated Hospital of Anhui University of Science and Technology,Huainan 232007,Anhui,China)

机构地区：[1]安徽理工大学第一附属医院麻醉科,安徽淮南232007

出　　处：《川北医学院学报》2023年第8期1074-1077,共4页Journal of North Sichuan Medical College

基　　金：安徽省淮南市指导性科技计划项目(2020-109)。

摘　　要：目的:探讨瑞芬太尼、丙泊酚复合异氟醚麻醉对腹腔镜全子宫切除术患者炎性因子及血流动力学的影响。方法:选取71例行腹腔镜全子宫切除术患者为研究对象,按照麻醉方案分为对照组(n=30)与观察组(n=41)。对照组患者采用瑞芬太尼复合丙泊酚麻醉方案;观察组患者在对照组的基础上给予异氟醚麻醉麻醉方案。比较两组患者麻醉效果、炎性因子及血流动力学指标水平。结果:两组患者手术时间、补液量、术中失血量、恢复自主呼吸时间、拔管时间、苏醒时间、住院天数比较,差异无统计学意义(P>0.05)。术后24 h,两组患者肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)水平均升高(P<0.05),且对照组高于观察组(P<0.05)。两组患者麻醉诱导前(T0)和手术结束10 min(T4)的心率(HR)、平均动脉压(MAP)比较,差异无统计学意义(P>0.05);观察组气管插管时(T1)、气腹后即刻(T2)及拔管即刻(T3)的HR、MAP低于对照组(P<0.05)。结论:瑞芬太尼、丙泊酚复合异氟醚麻醉有利于降低腹腔镜全子宫切除术患者降低炎性因子水平,减轻炎症反应,促进血流动力学平稳,值得临床推广应用。Objective:To investigate the effects of remifentanil,propofol combined with isoflurane on inflammatory factors and hemodynamics in patients undergoing laparoscopic total hysterectomy.Methods:A total of 71 patients undergoing laparoscopic hysterectomy were selected and divided into the control group(n=30)and the observation group(n=41)according to the anesthesia plan.The control group received remifentanil combined with propofol anesthesia scheme,and the observation group received isoflurane anesthesia on the basis of the control group.The anesthetic effect,inflammatory factors and hemodynamic indexes were compared between the two groups.Results:There was no significant difference between the two groups in operation time,fluid volume,intraoperative blood loss,recovery time of spontaneous breathing,extubation time,recovery time and hospitalization days(P>0.05).The levels of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)24 h after surgery were higher than those before surgery(P<0.05),and the observation group was lower than the control group(P<0.05).There were no differences in heart rate(HR)and mean arterial pressure(MAP)between the two groups before anesthesia induction(T0)and 10 min after surgery(T4)(P>0.05).HR and MAP of the observation group were lower than those of the control group during endotracheal intubation(T1),immediately after pneumoperitoneum(T2)and immediately after extubation(T3)(P<0.05).Conclusion:Remifentanil and propofol combined with isoflurane can reduce inflammatory response,reduce inflammatory factor levels and promote hemodynamic stability in patients with laparoscopic total hysterectomy,which is worthy of clinical application.

关 键 词：腹腔镜全子宫切除术 瑞芬太尼、丙泊酚 异氟醚 炎性因子 血流动力学 

分 类 号：R713.4[医药卫生—妇产科学]