CAJ | 학술논문

目的：探讨两种不同浓度的七氟醚复合丙泊酚静-吸复合麻醉对肝脏部分切除术患者术后苏醒质量的影响。方法选择择期行肝脏部分切除术的患者78例,年龄20~70岁,随机分为丙泊酚全凭静脉麻醉组(T 组)、0.5 MAC 七氟醚复合丙泊酚静-吸复合麻醉组(S1组)、1.0 MAC 七氟醚复合丙泊酚静-吸复合麻醉组(S2组),每组26例。术毕分别记录自主呼吸恢复时间、苏醒时间、拔管时间及改良 Aldrete 评分达到9分的时间；并于拔管后即刻(T1)、拔管后5 min(T2)、15 min (T3)、30 min(T4)对三组患者进行改良 OAA/S 评分及改良 Aldrete 评分；记录苏醒期躁动发生情况。结果 S1、S2组丙泊酚用量明显少于 T 组,且 S2组明显少于 S1组(P <0.05)。S1、S2组苏醒时间、拔管时间及改良 Aldrete 评分达到9分的时间明显短于 T 组(P <0.05)；S1、S2组 T1、T2时改良 OAA/S 评分、T1时改良 Aldrete 评分均明显高于 T 组,且 S2组明显高于 S1组(P <0.05)。结论与丙泊酚全凭静脉麻醉比较,0.5 MAC 及1.0 MAC 七氟醚复合丙泊酚静-吸复合麻醉更有助于提高肝脏部分切除术患者术后的苏醒质量,且1.0 MAC 七氟醚复合丙泊酚静-吸复合麻醉术后苏醒时间较短。
목적：탐토량충불동농도적칠불미복합병박분정-흡복합마취대간장부분절제술환자술후소성질량적영향。방법선택택기행간장부분절제술적환자78례,년령20~70세,수궤분위병박분전빙정맥마취조(T 조)、0.5 MAC 칠불미복합병박분정-흡복합마취조(S1조)、1.0 MAC 칠불미복합병박분정-흡복합마취조(S2조),매조26례。술필분별기록자주호흡회복시간、소성시간、발관시간급개량 Aldrete 평분체도9분적시간；병우발관후즉각(T1)、발관후5 min(T2)、15 min (T3)、30 min(T4)대삼조환자진행개량 OAA/S 평분급개량 Aldrete 평분；기록소성기조동발생정황。결과 S1、S2조병박분용량명현소우 T 조,차 S2조명현소우 S1조(P <0.05)。S1、S2조소성시간、발관시간급개량 Aldrete 평분체도9분적시간명현단우 T 조(P <0.05)；S1、S2조 T1、T2시개량 OAA/S 평분、T1시개량 Aldrete 평분균명현고우 T 조,차 S2조명현고우 S1조(P <0.05)。결론여병박분전빙정맥마취비교,0.5 MAC 급1.0 MAC 칠불미복합병박분정-흡복합마취경유조우제고간장부분절제술환자술후적소성질량,차1.0 MAC 칠불미복합병박분정-흡복합마취술후소성시간교단。
Objective To observe effects of different concentrations of sevoflurane combined with propofol on recovery quality in patients undergoing partial hepatic resection.Methods Seventy-eight patients,aged 20-70 years old,selected for partial hepatic resection were randomly divided into three groups,26 patients in each group:total intravenous propofol anesthesia group (group T), propofol combined with 0.5 MAC sevoflurane anesthesia group (group S1),propofol combined with 1.0 MAC sevoflurane anesthesia group (group S2).Spontaneous respiration recovery time,recovery time,extubation time and modified Aldrete score of 9 time were recorded after operation.Modified OAA/S scores as well as modified Aldrete score at extubation immediate time (T1 )and 5 min (T2 ), 1 5 min(T3 ),30 min(T4 )after extubation were also recorded.Results Total amount of propofol in groups S1,S2 significantly less than group T and total amount of propofol in group S2 significantly less than group S1(P <0.05).The recovery time,extubation time,modified Aldrete score of 9 time in groups S1 and S2 were significantly shorter than group T (P <0.05).Modified OAA/S scores at T1 ,T2 and the modified Aldrete scores at T1 in both groups S1 and S2 were significantly higher than group T,while group S2 was significantly higher than group S1 (P <0.05).Conclusion Compared with total intravenous propofol anesthesia,both propofol combined with 0.5 MAC sevoflurane and propofol combined with 1.0 MAC sevoflurane anesthesia improves the recovery quality in patients un-dergoing partial hepatic resection,and the recovery time was decreased in propofol combined with 1.0 MAC sevoflurane anesthesia.