CAJ | 학술논문

目的：观察不同浓度舒芬太尼联合丙泊酚在乳腺良性肿块切除术中的麻醉效果。方法选择2011年12月至2013年12月解放军第91中心医院收治的择期行乳腺良性肿块切除术患者205例，按照随机数字表法分为A组70例、B组69例、C组66例。麻醉诱导时分别调节三组患者血浆靶浓度为0．3、0．5及0．8μg／kg，比较三组患者麻醉诱导前（T0）、诱导后（T1）、气管插管时（T2）、手术切皮时（T3）、切皮后5 min（T4）及术毕（T5）6个时间段心率（HR）、平均动脉压（MAP）的水平变化。同时记录三组患者呼吸恢复时间、苏醒时间及不良反应情况。结果麻醉诱导后三组患者HR及MAP水平均较诱导前显著下降；A组患者在手术切皮时HR及MAP水平高于麻醉诱导后，B组患者HR及MAP水平T2～T5时间段处在相对较高水平，C组患者T1及T2～T4时间段HR和MAP水平均处在较低水平且比较稳定，三组不同时点间HR、MAP的水平变化比较，差异均有统计学意义（P ＜0．05）。三组患者呼吸恢复时间、苏醒时间及不良反应发生率比较，差异无统计学意义（P＞0．05）。结论应用丙泊酚联合较高浓度（0．8μg／kg）舒芬太尼可以使麻醉效果更加有效，且保证患者手术期间的血流动力稳定性，同时不会加重不良反应。
목적：관찰불동농도서분태니연합병박분재유선량성종괴절제술중적마취효과。방법선택2011년12월지2013년12월해방군제91중심의원수치적택기행유선량성종괴절제술환자205례，안조수궤수자표법분위A조70례、B조69례、C조66례。마취유도시분별조절삼조환자혈장파농도위0．3、0．5급0．8μg／kg，비교삼조환자마취유도전（T0）、유도후（T1）、기관삽관시（T2）、수술절피시（T3）、절피후5 min（T4）급술필（T5）6개시간단심솔（HR）、평균동맥압（MAP）적수평변화。동시기록삼조환자호흡회복시간、소성시간급불량반응정황。결과마취유도후삼조환자HR급MAP수평균교유도전현저하강；A조환자재수술절피시HR급MAP수평고우마취유도후，B조환자HR급MAP수평T2～T5시간단처재상대교고수평，C조환자T1급T2～T4시간단HR화MAP수평균처재교저수평차비교은정，삼조불동시점간HR、MAP적수평변화비교，차이균유통계학의의（P ＜0．05）。삼조환자호흡회복시간、소성시간급불량반응발생솔비교，차이무통계학의의（P＞0．05）。결론응용병박분연합교고농도（0．8μg／kg）서분태니가이사마취효과경가유효，차보증환자수술기간적혈류동력은정성，동시불회가중불량반응。
Objective To observe anesthetic effect of different concentrations of sufentanil combined with propofol in benign breast lumpectomy .Methods A total of 205 cases of benign breast lumps patients admitted for lumpectomy in PLA 91st Central Hospital from Dec.2011 to Dec.2013 were divided into group A(70 cases), group B(69 cases) and group C(66 cases) according to random-number table method.Target plasma concentra-tions of anesthesia induction in the patients were adjusted to 0.3,0.5 and 0.8 μg/kg,the level changes of HR and MAP before induction of anesthesia ( T0 ) , after induction ( T1 ) , endotracheal intubation ( T2 ) , surgical incision (T3),5 min (T4) and surgery over(T5) of patients were compared.Meanwhile the patients'breathing recovery time ,awkening time and adverse reactions of the three groups were recordede .Results After induction of anesthe-sia, HR and MAP level of the three groups were significantly decreased;HR and MAP level in group A at incision were higher than after induction;HR and MAP level of group B remained on a relatively high level during T 2-T5 , while HR and MAP of group C remained low and steady at T1 and T2-T4 period; HR,MAP levels of the three groups at different time points were statistically significantly different(P<0.05).Patients breathing recovery time, awakening time and adverse reactions of the three groups were not statistically significantly different (P>0.05). Conclusion Higher concentrations of sufentanil(0.8 μg/kg) with propofol is more effective,which can ensure the dynamic stability of blood flow in patients during surgery and will not increase adverse reactions .