中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
18期
23-26
,共4页
邓超%代志刚%陈咏今%董希伟
鄧超%代誌剛%陳詠今%董希偉
산초%대지강%진영금%동희위
麻醉%腹腔镜%细胞因子类%妇科手术
痳醉%腹腔鏡%細胞因子類%婦科手術
마취%복강경%세포인자류%부과수술
Anesthesia%Laparoscopes%Cytokines%Gynecologic operation
目的 探讨七氟烷和丙泊酚对腹腔镜全子宫切除术患者白细胞介素(IL)-6、IL-10的影响.方法 将50例择期行腹腔镜全子宫切除术患者按随机数字表法分为七氟烷组和丙泊酚组,每组25例.诱导后,调整七氟烷组七氟烷吸入浓度,丙泊酚组丙泊酚泵入速度,维持脑电双频指数(BIS)在50±5.记录麻醉前5 min(T1)、气腹后10 min(T2)、气腹后40 min(T3)和手术结束前5 min (T4)心率、平均动脉压(MAP)、BIS；采集外周静脉血,测定IL-6、IL-10.结果 两组组内和组间BIS、心率、MAP比较差异均无统计学意义(P＞0.05).两组T2～T4时IL-6、IL-10高于本组T1时[七氟烷组:(31.0±9.0)、(33.0±11.0)、(34.0±16.0) ng/L比(29.0±8.0) ng/L,(19.3±1.7)、(24.0±2.8)、(27.0±8.0) ng/L比(2.0±0.4)ng/L;丙泊酚组:(38.0±9.0)、(40.0±12.0)、(45.0±18.0) ng/L比(29.0±11.0) ng/L,(8.2±2.3)、(11.0±4.2)、(18.0±7.0) ng/L比(2.0±0.3) ng/L],差异有统计学意义(P＜0.05)；两组T1时IL-6、IL-10比较差异无统计学意义(P＞0.05),七氟烷组T2～T4时IL-6均低于丙泊酚组,IL-10均高于丙泊酚组,差异有统计学意义(P＜0.05).结论 在腹腔镜全子宫切除术期间对维持细胞因子的平衡方面,七氟烷较丙泊酚更有效,更适合用于腹腔镜全子宫切除术的麻醉维持.
目的 探討七氟烷和丙泊酚對腹腔鏡全子宮切除術患者白細胞介素(IL)-6、IL-10的影響.方法 將50例擇期行腹腔鏡全子宮切除術患者按隨機數字錶法分為七氟烷組和丙泊酚組,每組25例.誘導後,調整七氟烷組七氟烷吸入濃度,丙泊酚組丙泊酚泵入速度,維持腦電雙頻指數(BIS)在50±5.記錄痳醉前5 min(T1)、氣腹後10 min(T2)、氣腹後40 min(T3)和手術結束前5 min (T4)心率、平均動脈壓(MAP)、BIS；採集外週靜脈血,測定IL-6、IL-10.結果 兩組組內和組間BIS、心率、MAP比較差異均無統計學意義(P＞0.05).兩組T2～T4時IL-6、IL-10高于本組T1時[七氟烷組:(31.0±9.0)、(33.0±11.0)、(34.0±16.0) ng/L比(29.0±8.0) ng/L,(19.3±1.7)、(24.0±2.8)、(27.0±8.0) ng/L比(2.0±0.4)ng/L;丙泊酚組:(38.0±9.0)、(40.0±12.0)、(45.0±18.0) ng/L比(29.0±11.0) ng/L,(8.2±2.3)、(11.0±4.2)、(18.0±7.0) ng/L比(2.0±0.3) ng/L],差異有統計學意義(P＜0.05)；兩組T1時IL-6、IL-10比較差異無統計學意義(P＞0.05),七氟烷組T2～T4時IL-6均低于丙泊酚組,IL-10均高于丙泊酚組,差異有統計學意義(P＜0.05).結論 在腹腔鏡全子宮切除術期間對維持細胞因子的平衡方麵,七氟烷較丙泊酚更有效,更適閤用于腹腔鏡全子宮切除術的痳醉維持.
목적 탐토칠불완화병박분대복강경전자궁절제술환자백세포개소(IL)-6、IL-10적영향.방법 장50례택기행복강경전자궁절제술환자안수궤수자표법분위칠불완조화병박분조,매조25례.유도후,조정칠불완조칠불완흡입농도,병박분조병박분빙입속도,유지뇌전쌍빈지수(BIS)재50±5.기록마취전5 min(T1)、기복후10 min(T2)、기복후40 min(T3)화수술결속전5 min (T4)심솔、평균동맥압(MAP)、BIS；채집외주정맥혈,측정IL-6、IL-10.결과 량조조내화조간BIS、심솔、MAP비교차이균무통계학의의(P＞0.05).량조T2～T4시IL-6、IL-10고우본조T1시[칠불완조:(31.0±9.0)、(33.0±11.0)、(34.0±16.0) ng/L비(29.0±8.0) ng/L,(19.3±1.7)、(24.0±2.8)、(27.0±8.0) ng/L비(2.0±0.4)ng/L;병박분조:(38.0±9.0)、(40.0±12.0)、(45.0±18.0) ng/L비(29.0±11.0) ng/L,(8.2±2.3)、(11.0±4.2)、(18.0±7.0) ng/L비(2.0±0.3) ng/L],차이유통계학의의(P＜0.05)；량조T1시IL-6、IL-10비교차이무통계학의의(P＞0.05),칠불완조T2～T4시IL-6균저우병박분조,IL-10균고우병박분조,차이유통계학의의(P＜0.05).결론 재복강경전자궁절제술기간대유지세포인자적평형방면,칠불완교병박분경유효,경괄합용우복강경전자궁절제술적마취유지.
Objective To study the effect of sevoflurane and propofol anesthetic techniques on interleukin (IL)-6 and IL-10 in patients with laparoscopic hysterectomy.Methods Fifty elective laparoscopic hysterectomy patients were randomly divided into sevoflurane group (25 patients) and propofol group (25 patients) who received either sevoflurane or propofol for their anesthesia.After induction,adjusted the sevoflurane inhalation concentration in sevoflurane group and propofol pumping speed in propofol group.Maintained the Bispectral index (BIS) value at 50 +5.Recorded heart rate (HR),mean arterial blood pressure (MAP),BIS,IL-6,IL-10 on 5 min before anesthesia (T1),10 min after pneumoperitoneum (T2),40 min after pneumoperitoneum (T3) and 5 ain before the end of the operation (T4),and compared.Results The level of BIS,HR,MAP in two groups and between two groups had no significant difference (P ＞ 0.05).The level of IL-6,IL-10 on T2-T4 were significantly higher than those on T1 [sevoflurane group:(31.0 ± 9.0),(33.0 ± 11.0),(34.0 ± 16.0) ng/L vs.(29.0 ± 8.0) ng/L and (19.3 ± 1.7),(24.0 ± 2.8),(27.0 ± 8.0) ng/L vs.(2.0 + 0.4) ng/L; propofol group:(38.0 ± 9.0),(40.0 + 12.0),(45.0 ± 18.0) ng/L vs.(29.0 + 11.0) ng/L and (8.2 ± 2.3),(11.0 ± 4.2),(18.0 ± 7.0) ng/L vs.(2.0 ± 0.3) ng/L] (P ＜ 0.05).The level of IL-6,IL-10 on T1 between two groups had no significant difference (P ＞ 0.05).The level of IL-6 on T2-T4 in sevoflurane group was significantly lower than that in propofol group and the level of IL-10 on T2-T4 in sevoflurane group was significantly higher than that in propofol group (P＜ 0.05).Conclusions At maintaining the balance of cytokines in laparoscopic hysterectomy,the effect of sevoflurane is better than propofol.Sevoflurane is more suitable for maintenance of anesthesia for laparoscopic gynecologic operation.
