腹腔镜下胆囊切除术麻醉中丙泊酚对呼吸功能和循环功能的影响  

Effect of propofol on respiratory function and circulatory function in anesthesia for laparoscopic cholecystectomy

作　　者：孙艳平 姜虎飞 鲁媛媛 赵娜[1] SUN Yanping;JIANG Hufei;LU Yuanyuan(Department of Anesthesiology,Fangshan Hospital,Beijing University of Chinese Medicine,Beijing 102400,China)

机构地区：[1]北京中医药大学房山医院麻醉科,北京市102400

出　　处：《河北医药》2025年第1期59-61,66,共4页Hebei Medical Journal

摘　　要：目的 探讨腹腔镜下胆囊切除术麻醉中丙泊酚对呼吸功能和循环功能的影响。方法 选取2020年7月至2021年12月就诊并拟行腹腔镜下胆囊切除术患者80例,采用随机数表法随机分为对照组和研究组,每组40例。对照组予以2%七氟醚吸入麻醉,研究组予以靶控输注丙泊酚静脉麻醉,比较2组患者麻醉前(T1)、气腹后10 min(T2)、手术结束即刻(T3)不同时点呼吸功能、循环功能变化。结果 研究组患者T2、T3时的呼气末二氧化碳(PETCO_(2))(34.02±1.47)mm Hg、(33.85±1.34)mm Hg,水平显著低于对照组(P<0.05)。研究组患者T2、T3时的平均动脉压(MAP)(91.99±4.61)mm Hg、(90.45±4.64)mmHg, HR(77.48±5.68)次/min、(76.11±4.13)次/min,乳酸值(1.55±0.42)mmol/L、(1.44±0.41)mmol/L水平显著低于对照组(P<0.05)。研究组各项苏醒时间包括自主呼吸恢复时间(3.44±0.21)min、拔管时间(4.31±1.25)min、唤醒睁眼时间(3.01±0.25)min均显著短于对照组,差异均有统计学意义(P<0.05)。结论 与七氟醚吸入麻醉相比,在腹腔镜下胆囊切除术中应用丙泊酚麻醉有利于维持呼吸、循环功能稳定,麻醉效果更优。Objective To investigate the effects of propofol on respiratory function and circulatory function in anesthesia for laparoscopic cholecystectomy.Methods A total of 80 patients who admitted to our hospital from July 2020 to December 2021 and planned to undergo laparoscopic cholecystectomy were recruited,and they were randomized to receive 2%sevoflurane-based inhalation anesthesia(control group)or target-controlled infusion with propofol-based intravenous anesthesia(study group).The changes in respiratory function and circulatory function were compared between groups before anesthesia(T1),10min after pneumoperitoneum(T2)and immediately after operation(T3).Results The partial pressure of end-tidal CO_(2)(PETCO_(2))of the study group at T2([34.02±1.47]mm Hg)and T3([33.85±1.34]mm Hg)was significantly lower than that of the control group(P<0.05).The mean arterial pressure(MAP)at T2(91.99±4.61)mmHg and T3(90.45±4.64)mmHg,heart rate(HR)at T2(77.48±5.68)times/min and T3(76.11±4.13)times/min,and lactic acid at T2(1.55±0.42)mmol/L and T3(1.44±0.41)mmol/L of the study group were significantly lower than those of control group(P<0.05).The recovery time of spontaneous respiration(3.44±0.21)min,extubation time(4.31±1.25)min and awakening time(3.01±0.25)min in the study group were significantly shorter than those in the control group(P<0.05).Conclusion The anesthesia effect in laparoscopic cholecystectomy is better in maintaining the stability of respiratory and circulation functions using propofol-based total intravenous anesthesia versus sevoflurane-based inhalation anesthesia.

关 键 词：腹腔镜下胆囊切除术 二异丙酚 七氟醚 呼吸功能 循环功能 

分 类 号：R614[医药卫生—麻醉学]