CAJ | 학술논문

目的比较两种不同全身麻醉方法对老年高血压病患者腹腔镜胆囊切除术应激反应的影响.方法将26例腹腔镜胆囊切除的老年高血压病患者随机分为两组:单纯丙泊酚靶控输注组(Ⅰ组)和丙泊酚靶控输注复合异氟醚组(Ⅱ组),每组13例.测定麻醉诱导前(T0)、气腹前5 min(T1)、二氧化碳气腹后10 min(T2)、放气后5 min(T3)的血糖(Glu)、血浆肾上腺素(E)、血清促肾上腺皮质激素(ACTH)、皮质醇(Cor)浓度.结果两组患者在T2、T3时Glu、E、ACTH、Cor均高于T0时;Ⅱ组在T2、T3时的Glu、E、ACTH、Cor均明显低于Ⅰ组(P<0.05).结论丙泊酚靶控输注复合异氟醚吸入与单纯丙泊酚靶控输注相比可明显减轻老年高血压病患者腹腔镜胆囊切除术的应激反应.
목적 비교량충불동전신마취방법대노년고혈압병환자복강경담낭절제술응격반응적영향.방법 장26례복강경담낭절제적노년고혈압병환자수궤분위량조:단순병박분파공수주조(Ⅰ조)화병박분파공수주복합이불미조(Ⅱ조),매조13례.측정마취유도전(T0)、기복전5 min(T1)、이양화탄기복후10 min(T2)、방기후5 min(T3)적혈당(Glu)、혈장신상선소(E)、혈청촉신상선피질격소(ACTH)、피질순(Cor)농도.결과 량조환자재T2、T3시Glu、E、ACTH、Cor균고우T0시;Ⅱ조재T2、T3시적Glu、E、ACTH、Cor균명현저우Ⅰ조(P<0.05).결론 병박분파공수주복합이불미흡입여단순병박분파공수주상비가명현감경노년고혈압병환자복강경담낭절제술적응격반응.
Objective To compare the effects of two different general anesthetic methods on the systemic stress response in aged patients with hypertension undergoing laparoscopic cholecystectomy. Methods Twenty-six ASA Ⅱ-Ⅲ aged patients with hypertension who undergoing laparescopic cholecystectomy were randomly divided into two groups, group Ⅰ (propofol TCI) and groupⅡ (propofol TCI plus isoflurane inhalation), all patients were induced with 2-3 μg/kg fcntanyl, 0.05 mg/kg midazolam,0.12 mg/kg vecuronium and 0.3 mg/kg etomidate. Anesthesia was maintained with different anesthetic methods. MAP, HR were recorded and blood samples were taken for the measurements of concentration of blood glucose (Glu), plasma epinephrine (E),ACTH and serum cortisol (Cor) before induce(T0),5 min before pneumoperitoneum(T1), 10 min after pneumoperitoneum(T2) and post-pneumoperitoneum(T3). Results MAP, HR in group Ⅱ were significantly lower than in group Ⅰ at T2,T3(P<0.05).GIu,E,ACTH and Cot were significantly higher in beth groups at T2,T3 than at TO ,compared with group Ⅰ, Glu,E,ACTH,Cor were significantly lower in group Ⅱ(P<0.05). Conclusion Compared with propofol TCI, propofol TCI plus isoflurane inhalation can relieve effectively the systemic stress response in aged patients with hypertension undergoing laparoscopie cholecystectomy.