中国药师
中國藥師
중국약사
CHINA PHARMACIST
2015年
1期
85-86,87
,共3页
丙泊酚%异氟烷%瑞芬太尼%腹腔镜%应激激素%血流动力学
丙泊酚%異氟烷%瑞芬太尼%腹腔鏡%應激激素%血流動力學
병박분%이불완%서분태니%복강경%응격격소%혈류동역학
Propofol%Isoflurane%Remifentanyl%Laparoscopic%Stress hormone%Hemodynamics
目的：：比较不同麻醉方式对妇科腹腔镜手术患者应激激素及血流动力学变化的影响。方法：采用回顾性分析方法,145例妇科腹腔镜手术患者按麻醉方式不同分为两组。对照组72例采用瑞芬太尼丙泊酚静脉麻醉,观察组73例采用丙泊酚复合异氟烷麻醉,对比两组患者不同时点收缩压( SBP)、舒张压( DBP)、心率( HR)等血流动力学指标,以及血浆去甲肾上腺素( NE)、肾上腺素( E )、血浆皮质醇( cort)与血管紧张素Ⅱ( ATⅡ)等应激激素水平变化。同时观察两组药品不良反应发生情况。结果：T2、T3时点两组SBP、DBP与HR均显著低于T0时点(P<0.05),且观察组SBP和HR低于同时点对照组(P<0.05)。 T2、T3时点两组NE、E、cort、ATⅡ水平均较T0时点明显上升(P<0.05),且观察组上升幅度低于对照组(P<0.05)。观察组呼吸抑制、低血压、心动过缓等不良反应发生率以及不良反应总发生率均明显低于对照组(P<0.05)。结论：丙泊酚复合异氟烷麻醉较之丙泊酚瑞芬太尼复合静脉麻醉,更有利于保持患者血流动力学的稳定,降低应激反应,且不良反应少,安全性高,值得临床推广使用。
目的：：比較不同痳醉方式對婦科腹腔鏡手術患者應激激素及血流動力學變化的影響。方法：採用迴顧性分析方法,145例婦科腹腔鏡手術患者按痳醉方式不同分為兩組。對照組72例採用瑞芬太尼丙泊酚靜脈痳醉,觀察組73例採用丙泊酚複閤異氟烷痳醉,對比兩組患者不同時點收縮壓( SBP)、舒張壓( DBP)、心率( HR)等血流動力學指標,以及血漿去甲腎上腺素( NE)、腎上腺素( E )、血漿皮質醇( cort)與血管緊張素Ⅱ( ATⅡ)等應激激素水平變化。同時觀察兩組藥品不良反應髮生情況。結果：T2、T3時點兩組SBP、DBP與HR均顯著低于T0時點(P<0.05),且觀察組SBP和HR低于同時點對照組(P<0.05)。 T2、T3時點兩組NE、E、cort、ATⅡ水平均較T0時點明顯上升(P<0.05),且觀察組上升幅度低于對照組(P<0.05)。觀察組呼吸抑製、低血壓、心動過緩等不良反應髮生率以及不良反應總髮生率均明顯低于對照組(P<0.05)。結論：丙泊酚複閤異氟烷痳醉較之丙泊酚瑞芬太尼複閤靜脈痳醉,更有利于保持患者血流動力學的穩定,降低應激反應,且不良反應少,安全性高,值得臨床推廣使用。
목적：：비교불동마취방식대부과복강경수술환자응격격소급혈류동역학변화적영향。방법：채용회고성분석방법,145례부과복강경수술환자안마취방식불동분위량조。대조조72례채용서분태니병박분정맥마취,관찰조73례채용병박분복합이불완마취,대비량조환자불동시점수축압( SBP)、서장압( DBP)、심솔( HR)등혈류동역학지표,이급혈장거갑신상선소( NE)、신상선소( E )、혈장피질순( cort)여혈관긴장소Ⅱ( ATⅡ)등응격격소수평변화。동시관찰량조약품불량반응발생정황。결과：T2、T3시점량조SBP、DBP여HR균현저저우T0시점(P<0.05),차관찰조SBP화HR저우동시점대조조(P<0.05)。 T2、T3시점량조NE、E、cort、ATⅡ수평균교T0시점명현상승(P<0.05),차관찰조상승폭도저우대조조(P<0.05)。관찰조호흡억제、저혈압、심동과완등불량반응발생솔이급불량반응총발생솔균명현저우대조조(P<0.05)。결론：병박분복합이불완마취교지병박분서분태니복합정맥마취,경유리우보지환자혈류동역학적은정,강저응격반응,차불량반응소,안전성고,치득림상추엄사용。
Objective:To compare the effects of different anesthesia methods on stress hormones and hemodynamic changes in the patients with gynecological laparoscopic surgery. Methods:Retrospective analysis was carried out. Totally 145 patients with gynecolog-ical laparoscopic surgery were divided into two groups according to the anesthesia method, the control group with 72 cases was given routine remifentanyl propofol intravenous anesthesia, and the observation group with 73 cases was given routine propofol isoflurane com-posite anesthesia. Such hemodynamic indices as SBP, DBP and HR, and plasma NE, E, cort and AT II levels at different time points in the two groups were studied and compared, and adverse drug reactions were also observed in the two groups. Results:The BP and HR at T2 and T3 time point in the two groups were significantly lower than those at T0 time point (P<0. 05), and those in the obser-vation group were lower than those in the control group at the same time point(P<0. 05). The levels of NE, E, cort and ATⅡat T2 and T3 time point in the two groups were significantly higher than those at T0 time point (P<0. 05), while the increase in the observa-tion group was lower than that in the control group (P<0. 05). The incidence of adverse drug reactions (ADR), such as respiratory depression, hypertension, bradycardia and so on, and the total incidence of ADR in the observation group were both lower than those in the control group (P<0. 05). Conclusion:Compared with remifentanyl propofol intravenous anesthesia, propofol isoflurane composite anesthesia can keep the hemodynamic stability more effectively and reduce the stress reaction with fewer ADR and promising safety, which is worthy of wider application in clinics.
