CAJ | 학술논문

目的：探讨腹腔镜手术应用丙泊酚靶控输注麻醉与七氟醚吸入麻醉的效果。方法选取腹腔镜手术患者120例，按照数字表法随机分为观察组和对照组各60例。观察组使用丙泊酚靶控输注进行麻醉，对照组使用七氟醚吸入进行麻醉。对患者麻醉诱导前（T1）、气管插管后即刻（T2）、手术开始即刻（T3）、气腹后10 min（T4）及手术结束即刻（T5）的血流动力学指标进行记录，并观察患者的不良反应和术后恢复情况。结果观察组其他时刻心率（ HR）与T1时刻比较差异无统计学意义（P＞0．05）；对照组T4时刻HR明显高于T1时刻，差异有统计学意义（P＜0．05）；观察组T4时刻平均动脉压（MAP）明显低于对照组，差异有统计学意义（ P＜0.05）；观察组睁眼时间、拔管时间、定向力恢复时间明显短于对照组，差异有统计学意义（P＜0．05）；观察组不良反应发生率明显低于对照组，差异有统计学意义（P＜0．01）。结论丙泊酚靶控输注用于腹腔镜手术麻醉对血流动力学影响小，不良反应发生率低，是一种安全可靠的麻醉方法，值得推广应用。
목적：탐토복강경수술응용병박분파공수주마취여칠불미흡입마취적효과。방법선취복강경수술환자120례，안조수자표법수궤분위관찰조화대조조각60례。관찰조사용병박분파공수주진행마취，대조조사용칠불미흡입진행마취。대환자마취유도전（T1）、기관삽관후즉각（T2）、수술개시즉각（T3）、기복후10 min（T4）급수술결속즉각（T5）적혈류동역학지표진행기록，병관찰환자적불량반응화술후회복정황。결과관찰조기타시각심솔（ HR）여T1시각비교차이무통계학의의（P＞0．05）；대조조T4시각HR명현고우T1시각，차이유통계학의의（P＜0．05）；관찰조T4시각평균동맥압（MAP）명현저우대조조，차이유통계학의의（ P＜0.05）；관찰조정안시간、발관시간、정향력회복시간명현단우대조조，차이유통계학의의（P＜0．05）；관찰조불량반응발생솔명현저우대조조，차이유통계학의의（P＜0．01）。결론병박분파공수주용우복강경수술마취대혈류동역학영향소，불량반응발생솔저，시일충안전가고적마취방법，치득추엄응용。
Objective To investigate the effects of target-directing propofol infusion anesthesia and sevoflurane inhalation an-esthesia in laparoscopic surgery .Methods One hundred and twenty laparoscopic surgical patients were selected and randomly divided into the observation group and the control group , each consisting of 60 patients .The observation group received target-directing propofol infusion anesthesia , while the control group had sevoflurane inhalation anesthesia .Hemodynamic indices were recorded at the following 5 time-points:before the induction of anesthesia ( T1 ) , the time right after intubation ( T2 ) , the moment after the start of surgery (T3), 10 min after pneumoperitoneum (T4) and the moment after the termination of surgery (T5).Adverse reactions and recovery of patients were closely observed after surgery .Results There was no statistical significance in the heart rate ( HR) at other time points for the observation group, as compared with T1 (P>0.05).The heart rate at T4 for the control group was significantly higher than that of T1(P<0.05).Mean arterial pressure (MAP) at T4 for the observation group was significantly lower than that of the control group (P<0.05).Patients in the observation group would open eyes in response to call , and the time of decannulation and orientation recov-ery was significantly shorter than that of the control group (P<0.05).Rate of adverse reactions for the observation group (5.00%) was considerably lower than that of the control group 21.67% (P<0.01).Conclusion Propofol target-directing infusion anesthesia used for laparoscopic surgery had the following advantages of less effect on the hemodynamics and lower rate of adverse reactions .For this reason , it was a safe and reliable anesthetic method worth further extension .