不同浓度七氟醚吸入对腹腔镜胆囊癌根治术患者血流动力学及应激反应指标的影响  

Effect of sevoflurane inhalation at different concentrations on hemodynamics and stress response indexes in patients undergoing laparoscopic radical resection for gallbladder cancer

作　　者：张立娜[1] 史艳平[1] ZHANG Li’na;SHI Yanping(Department of Anesthesiology,Hohhot First Hospital,Hohhot 010030,Inner Mongolia,China)

机构地区：[1]呼和浩特市第一医院麻醉科,呼和浩特010030

出　　处：《癌症进展》2024年第16期1762-1765,共4页Oncology Progress

基　　金：内蒙古自治区科技计划项目(CX202407060023)。

摘　　要：目的探讨不同浓度七氟醚吸入对腹腔镜胆囊癌根治术患者血流动力学及应激反应指标的影响。方法根据麻醉过程中吸入七氟醚浓度的不同将60例腹腔镜胆囊癌根治术患者分为低剂量组[n=21,0.5最小肺泡浓度(MAC)]、中剂量组(n=20,1.0MAC)和高剂量组(n=19,1.5MAC)。比较两组患者的血流动力学指标[脉搏血氧饱和度(SpO_(2))、平均动脉压(MAP)、心率(HR)]、应激反应指标[肾上腺素(E)、去甲肾上腺素(NE)]及不良反应发生情况。结果麻醉诱导后、气管插管1 min、气管插管10 min,3组患者SpO_(2)、MAP、HR均低于本组麻醉前,低剂量组和高剂量组患者SpO_(2)、MAP、HR均低于中剂量组,差异均有统计学意义(P﹤0.05)。麻醉诱导后10 min、气腹建立30 min、术毕30 min,3组患者E、NE水平均低于本组麻醉诱导前10 min,低剂量组和高剂量组患者E、NE水平均高于中剂量组,差异均有统计学意义(P﹤0.05)。3组患者的不良反应总发生率比较,差异无统计学意义(P﹥0.05)。结论1.0MAC七氟醚吸入可维持腹腔镜胆囊癌根治术患者的血流动力学稳定,减轻应激反应,且具有一定的安全性。Objective To explore the effect of sevoflurane inhalation at different concentrations on hemodynamics and stress response indexes in patients undergoing laparoscopic radical resection for gallbladder cancer.Method Accord-ing to the concentration of sevoflurane inhalation during anesthesia,60 patients undergoing laparoscopic radical resection for gallbladder cancer were divided into low-dose group[n=21,0.5 minimum alveolar concentration(MAC)],medium dose group(n=20,1.0MAC)and high-dose group(n=19,1.5MAC).The hemodynamic indexes[pulse oxygen saturation(SpO_(2)),mean arterial pressure(MAP),heart rate(HR)],stress response indexes[epinephrine(E),norepinephrine(NE)]and the occurrence of adverse reactions were compared between the two groups.Result After induction of anesthesia,1 min and 10 min of tracheal intubation,the SpO_(2),MAP and HR in the three groups were lower than those before anesthe-sia,and the SpO_(2),MAP and HR in low-dose group and high-dose group were lower than those in medium-dose group,and the differences were statistically significant(P<0.05).At 10 min after anesthesia induction,30 min after pneumoperi-toneum establishment,and 30 min after surgery,the E and NE levels in the three groups were lower than those 10 min be-fore anesthesia induction,and the E and NE levels in low-dose group and high-dose group were higher than those in medi-umdose group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions among the three groups(P>0.05).Conclusion 1.0MAC sevoflurane inhalation can main-tain hemodynamic stability and reduce stress response in patients undergoing laparoscopic radical resection for gallblad-der cancer,and has a certain safety.

关 键 词：七氟醚 腹腔镜胆囊癌根治术 血流动力学 应激反应 

分 类 号：R735.8[医药卫生—肿瘤]