艾司氯胺酮复合丙泊酚对于腹腔镜全子宫切除术患者血流动力学与不良反应的影响  

The Effect of Ketamine Combined with Propofol on Hemodynamics and Adverse Reactions in Patients Undergoing Laparoscopic Total Hysterectomy

作　　者：王绮琪 WANG Qiqi(Xiamen Maternal and Child Health Hospital,Xiamen 361003,China)

机构地区：[1]厦门大学附属妇女儿童医院(厦门市妇幼保健院),福建厦门361003

出　　处：《中外医学研究》2025年第6期119-122,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析艾司氯胺酮复合丙泊酚对于腹腔镜全子宫切除术患者血流动力学与不良反应的影响。方法:选取2023年1月—2024年8月在厦门大学附属妇女儿童医院(厦门市妇幼保健院)接受腹腔镜子宫全切除术治疗的75例患者作为研究对象,按照随机数表法分为对照组(37例)与研究组(38例)。对照组使用舒芬太尼复合丙泊酚进行麻醉诱导,研究组使用艾司氯胺酮复合丙泊酚进行麻醉诱导,两组其他麻醉方法相同。比较两组血流动力学、应激反应、炎性反应、不良反应发生情况等。结果:插管前即刻、插管后1 min、插管后3 min,研究组平均动脉压(MAP)均高于对照组,差异有统计学意义(P<0.05)。术后24 h,研究组白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)均低于对照组,差异有统计学意义(P<0.05)。术后24 h,研究组肾上腺素(ADR)、去甲肾上腺素(NE)均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:艾司氯胺酮复合丙泊酚用于腹腔镜全子宫切除术,有利于减轻患者血流动力学波动和应激反应,降低炎性反应水平,而且不良反应少,具有较好的麻醉效果。Objective:To analyze the effects of ketamine combined with propofol on hemodynamics and adverse reactions in patients undergoing laparoscopic total hysterectomy.Method:A total of 75 patients who received total laparoscopic hysterectomy in Women and Children's Hospital Affiliated to Xiamen University(Xiamen Maternal and Child Health Hospital)from January 2023 to August 2024 were selected as the study objects,and were divided into control group(37 cases)and study group(38 cases)according to random number table method.Sufentanil combined with propofol was used to induce anesthesia in the control group,while ketamine combined with propofol was used in the study group.Other anesthesia methods were the same in the two groups.The hemodynamics,stress response,inflammatory response and occurrence of adverse reactions were compared between the two groups.Result:The mean arterial pressure(MAP)of the study group immediately before intubation,1 min after intubation,3 min after intubation was higher than that of control group,and the difference was statistically significant(P<0.05).24 h after operation,interleukin-6 in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).24 h after operation,the ADR and NE of the study group were lower than those of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Ketamine combined with propofol in laparoscopic total hysterectomy is beneficial to reduce the hemodynamic fluctuation and stress response of patients,reduce the level of inflammatory response,and have less adverse reactions,and have a better anesthetic effect.

关 键 词：艾司氯胺酮 丙泊酚 腹腔镜全子宫切除术 血流动力学 不良反应 

分 类 号：R614[医药卫生—麻醉学]