异丙酚与舒芬太尼静脉复合麻醉在异位妊娠腹腔镜手术中的应用效果  

Application effect of intravenous anesthesia combined with propofol and sufentanil in laparoscopic surgery of ectopic pregnancy

作　　者：解飞 吕小倩 徐夏[1] XIE Fei;LYU Xiao-qian;XU Xia(Department of Anesthesia Surgery,Sanya Central Hospital(The Third People's Hospital of Hainan Province),Sanya Hainan 572000,China;Department of Anesthesiology,Sanya Women and Children's Hospital,Sanya Hainan 572022,China)

机构地区：[1]三亚中心医院(海南省第三人民医院)麻醉手术科,海南三亚572000 [2]三亚市妇女儿童医院麻醉科,海南三亚572022

出　　处：《临床和实验医学杂志》2023年第20期2230-2234,共5页Journal of Clinical and Experimental Medicine

基　　金：海南省卫生健康行业科研项目(编号:20A200320)。

摘　　要：目的研究异丙酚与舒芬太尼静脉复合麻醉在异位妊娠腹腔镜手术中的应用效果。方法以回顾性分析为法,研究对象为2021年1月至2023年1月三亚中心医院收治入院的100例异位妊娠腹腔镜手术患者,按照麻醉方式不同分为对照组(n=50)与研究组(n=50)。研究组行舒芬太尼、异丙酚静脉复合麻醉,对照组行瑞芬太尼、异丙酚静脉复合麻醉。比较两组患者的麻醉相关指标(气管拔管时间、定向力恢复时间、自主呼吸恢复时间、苏醒睁眼时间、意识消失时间),麻醉前与术后30 min时的炎症细胞因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)]、应激指标[皮质醇、血管紧张素Ⅱ(Ang-Ⅱ)、内皮素-1],术后2、6、12、24 h的Ramsay镇静评分、视觉模拟评分法(VAS)镇痛评分,麻醉前、手术开始后10 min、手术结束时、术后30 min的血流动力学指标(收缩压、舒张压、心率)水平和并发症发生情况。结果研究组患者气管拔管时间、定向力恢复时间、自主呼吸恢复时间、苏醒睁眼时间及意识消失时间均明显短于对照组,差异均有统计学意义(P<0.05)。研究组患者术后30 min的CRP、IL-6、皮质醇、Ang-Ⅱ、内皮素-1水平均明显低于对照组,差异均有统计学意义(P<0.05)。研究组患者术后2、6、12 h的Ramsay镇静评分与术后2、6、12、24 h的VAS镇痛评分均明显低于对照组,差异均有统计学意义(P<0.05)。研究组患者手术开始后10 min、手术结束时、术后30 min的收缩压、心率均明显低于对照组,手术开始后10 min、手术结束时舒张压均明显低于对照组,差异均有统计学意义(χ^(2)=4.536,P=0.033)。研究组患者术后并发症发生率为8.00%,明显低于对照组(26.00%),差异有统计学意义(P<0.05)。结论异丙酚、舒芬太尼静脉复合麻醉用于异位妊娠腹腔镜手术中的效果显著,可进一步减轻患者机体炎症反应、应激反应及疼痛程度,有效控制麻醉期间心血管�Objective To study the effect of intravenous anesthesia combined with propofol and sufentanil in laparoscopic surgery of ectopic pregnancy.Methods By retrospective analysis,100 patients with ectopic pregnancy undergoing aparoscopic surgery admitted to Sanya Central Hospital from January 2021 to January 2023 were divided into control group(n=50)and study group(n=50)according to different anesthesia methods.The study group was given sufentanil and propofol intravenous anesthesia,the control group was given intravenous compound anesthesia with remifentanil and propofol.Anesthesia related indicators(tracheal extubation time,directional recovery time,spontaneous breathing recovery time,awakening and eye opening time,consciousness disappearance time),inflammatory cytokines[C reactive protein(CRP),interleukin-6(IL-6)],stress indicators[cortisol,angiotensinⅡ(Ang-Ⅱ),endothelin-1]at before anesthesia and 30 minutes after operation,Ramsay sedation scores and visual analogue scale(VAS)at 2,6,12,and 24 hours after operation,and hemodynamic indicators(systolic blood pressure,diastolic blood pressure,heart rate)at 10 minutes after operation,at the end of operation,and 30 minutes after operation,and complications were compared between the two groups.Results The time for tracheal extubation,directional recovery,spontaneous breathing recovery,awakening,eye opening,and consciousness disappearance in the study group patients were significantly shorter than those in the control group,the differences were statistically significant(P<0.05).The levels of CRP,IL-6,cortisol,Ang-Ⅱand endothelin-1 in the study group were significantly lower than those in the control group 30 min after operation,the differences were statistically significant(P<0.05).Ramsay sedation scores at 2,6 and 12 h after operation and VAS analgesia scores at 2,6,12 and 24 h after operation in the study group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).The systolic blood pressure and heart rate of

关 键 词：异位妊娠 腹腔镜手术 静脉复合麻醉 异丙酚 舒芬太尼 

分 类 号：R614[医药卫生—麻醉学]