七氟醚与丙泊酚联合瑞芬太尼在输尿管镜碎石取石术中的麻醉效果比较  

Effectiveness,Stress and Prognosis of Sevoflurane Combined with Remifentanil Versus Propofol Combined with Remifentanil in Anaesthesia for Ureteroscopic Lithotripsy for Stone Extraction

作　　者：郭济东 GUO Jidong(Department of Anesthesiology,Nanjing Jiangning Hospital,Nanjing 211100,China)

机构地区：[1]南京市江宁医院麻醉科,江苏南京211100

出　　处：《湖北民族大学学报(医学版)》2025年第1期43-46,共4页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的比较七氟醚联合瑞芬太尼与丙泊酚联合瑞芬太尼在输尿管镜碎石取石术中的麻醉效果。方法选取2022年7月-2024年6月南京市江宁医院行输尿管镜取石术患者98例,采用随机数表法分为对照组和研究组,每组各49例,对照组给予丙泊酚复合瑞芬太尼进行麻醉,研究组给予七氟醚复合瑞芬太尼进行麻醉,记录并比较两组麻醉前(T0)、手术开始后10 min(T1)、手术结束后10 min(T2)的血流动力学指标[心率(HR)、平均动脉压(MAP)、血氧饱和度(SPO_(2))、去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(Cor)]和麻醉效果。结果研究组拔管、定向力恢复、言语应答、自主呼吸恢复时间明显短于对照组(P<0.05)。在T1、T2时,研究组HR、MAP、NE、E、Cor与T0时比较,差异无统计学意义(P>0.05),对照组较T0时均升高(P<0.05),研究组均明显低于对照组(P<0.05)。结论与丙泊酚复合瑞芬太尼相比较,七氟醚复合瑞芬太尼应用于输尿管镜取石术,能更有效稳定血流动力学指标,减轻应激反应,麻醉效果更好。Objective To compare the effectiveness,stress and prognosis of Sevoflurane combined with Remifentanil versus Propofol combined with Remifentanil in anaesthesia for ureteroscopic lithotripsy for stone extraction.Methods 98 patients who underwent ureteroscopic lithotripsy in hospital from July 2022 to June 2024 were randomly divided into two groups:control group and study group,with 49 patients in each group.The control group was anesthetized with Propofol combined with Remifentanil,and the study group was anesthetized with Sevoflurane combined with Remifentanil.Hemodynamic indexes of heart rate(HR),mean arterial pressure(MAP),blood oxygen saturation(SPO_(2)),norepinephrine(NE),epinephrine(E),cortisol(Cor)before anesthesia(T0),10 minutes after surgery(T1),and 10 min after the operation(T2),and the anesthetic effect was evaluated.Results The extubation time,directional recovery time,speech response time,and spontaneous breathing recovery time of the study group were significantly shorter than those of the control group(P<0.05).At T1 and T2,HR,MAP,NE,E,Cor in the study group had no changes compared with that at T0(P>0.05),while those in the control group were higher than those at T0(P<0.05),and those in the study group were significantly lower than those in the control group(P<0.05).Conclusion Compared with Propofol combined with Remifentanil,Sevoflurane combined with Remifentanil in ureteroscopic lithotripsy can more effectively stabilize hemodynamic indicators,reduce stress reaction,have better anesthetic effect.

关 键 词：七氟醚 丙泊酚 瑞芬太尼 输尿管镜取石术 麻醉效果 应激反应 

分 类 号：R614[医药卫生—麻醉学]