老年腹腔镜胆囊切除术中七氟烷或异丙酚复合瑞芬太尼的临床麻醉对患者血流动力学的影响分析  

Evaluation of the Effect of Clinical Anesthesia with Sevoflurane or Propo⁃fol Combined with Remifentanil on Hemodynamics in Elderly Patients Un⁃dergoing Laparoscopic Cholecystectomy

作　　者：钱瑛 QIAN Ying(Anesthesia Department,Haimen District Traditional Chinese Medicine Hospital,Nantong City,Nantong 226100,Ji-angsu,China)

机构地区：[1]南通市海门区中医院麻醉科,江苏南通226100

出　　处：《系统医学》2025年第1期76-79,共4页Systems Medicine

摘　　要：目的分析在老年腹腔镜胆囊切除术中,七氟烷或异丙酚复合瑞芬太尼的麻醉的临床优势。方法非随机选取2021年1月—2023年12月南通市海门区中医院86例行腹腔镜胆囊切除术治疗的老年患者为研究对象,根据麻醉方法不同分为两组,各43例,七氟烷复合瑞芬太尼麻醉维持为观察组;异丙酚复合瑞芬太尼麻醉维持为对照组,比较两组入室后血流动力学数据、麻醉效果及并发症发生率。结果观察组在插管时、拔管时的平均动脉压、心率优于对照组,差异有统计学意义(P均<0.05)。观察组并发症发生率为6.98%(3/43),优于对照组的23.26%(10/43),差异有统计学意义(χ^(2)=4.440,P<0.05)。观察组的自主呼吸恢复时间、拔管时间及术后1 d的疼痛评分均优于对照组,差异有统计学意义(P均<0.05)。结论腹腔镜胆囊切除术采用七氟烷复合瑞芬太尼麻醉维持具有显著的临床优势,有利于稳定老年患者生命体征及血流动力学,并发症少,麻醉效果更好。Objective To analyze the anesthesia effect of sevoflurane or propofol combined with remifentanil during laparoscopic cholecystectomy in elderly patients.Methods Eighty-six elderly patients who underwent laparoscopic cholecystectomy at Haimen District Traditional Chinese Medicine Hospital in Nantong City from January 2021 to De⁃cember 2023 were non-randomly selected as the study subjects.They were divided into two groups according to the different anesthesia methods,with forty-three cases in each group,sevoflurane combined with remifentanil anesthesia maintained as the observation group,propofol combined with remifentanil anesthesia maintenance as the control group,and the hemodynamic data after admission,anesthesia effect,and incidence of complications were compared be⁃tween the two groups.Results The average arterial pressure,heart rate in the observation group during intubation and extubation were better than those in the control group,and the differences were statistically significant(all P<0.05).The incidence of complications in the observation group was 6.98%(3/43),better than 23.26%(10/43)in the control group,and the difference was statistically significant(χ^(2)=4.440,P<0.05).The recovery time of spontaneous respira⁃tion,extubation time,and pain score on the first day after surgery in the observation group were better than those in the control group, and the differences were statistically significant (all P<0.05). Conclusion Laparoscopic cholecystec⁃ tomy maintained by sevoflurane combined with remifentanil anesthesia is beneficial for stabilizing vital signs and he⁃ modynamics in elderly patients, with fewer complications and better anesthesia effect.

关 键 词：老年 腹腔镜胆囊切除术 七氟烷 异丙酚 复合瑞芬太尼麻醉 血流动力学 

分 类 号：R614[医药卫生—麻醉学]