异丙酚麻醉下行人工流产术对机体应激激素的影响  

Influence of STOP under propofol anesthesia on stress hormone

作　　者：刘丹彦[1] 房秀生[1] 

机构地区：[1]重庆医科大学临床学院麻醉科,重庆400016

出　　处：《重庆医科大学学报》2003年第5期644-646,共3页Journal of Chongqing Medical University

摘　　要：目的 :观察在异丙酚麻醉下行人工流产手术对机体应激激素的影响。方法 :选择美国麻醉医师协会 (ASA)病情分级　Ⅰ -Ⅱ级 (对麻醉和手术耐受良好 )的早孕患者 6 6例 ,随机分为两组 ;C组 (n =32 )为传统的人流手术在无麻醉下进行 ;P组(n =34)为异丙酚麻醉下的无痛人工流产手术。术中均连续监测BP、HR、SpO2 ,并于术前、术后 5min分别检测血浆皮质醇、血糖、胰岛素、C肽、生长激素等应急激素水平。结果 :C组患者心率在术中即开始出现下降 ,与术前比较有显著差异 ,至术毕时下降更为明显且伴有血压的下降 ,与术前比较有非常显著差异P <0 .0 1。P组患者血压在术中、术后较术前均有明显下降P <0 .0 1,而心率下降与术前比较则无统计学意义。两组间比较血压、心率有显著的差异P <0 .0 1。C组血浆皮质醇术后增高较术前有显著差异P <0 .0 5 ,其它各指标无明显变化。P组各指标均无明显变化。两组术后皮质醇比较有显著差异P <0 .0 5。结论 :在异丙酚麻醉下行人工流产手术不仅避免了传统人流手术所至人流综合征给机体带来的危害 ,而且不干扰机体的内分泌功能。Objective:To determine the influence of STOP(suction termination of pregnancy) with propofol anesthesia on stress hormone in the patients.Methods:Early pregnant patients of ASA Ⅰ-Ⅱ grade were divided randomly into two groups.The group C( n =32),as control group,received no anesthetic agent during STOP.The group P( n =34) was intervened with propofol anesthesia.BP,HR,So 2% were measured continuously during STOP.Blood samples were obtained from 66 patients at the following intervals:before STOP and 5min after STOP,and the plasma cortisol,blood sugar,insulin,C-peptide and growth hormone levels were measured.Results:The BP and HR decreased significantly during STOP and after STOP in group C compared with group P.The cortisol level in group C increased obviously aftr STOP.The significant difference in cortisol level was observed between two groups.Conclusion:STOP under propofol anesthesia could avoid the harm from the STOP syndrome and would not disturb the endocrine system of the patients.

关 键 词：异丙酚 人工流产术 应激激素 全身麻醉 

分 类 号：R169.42[医药卫生—公共卫生与预防医学] R614.2