中国当代医药
中國噹代醫藥
중국당대의약
PERSON
2015年
21期
50-53
,共4页
梁大海%江帆%叶伟%侯利军
樑大海%江帆%葉偉%侯利軍
량대해%강범%협위%후리군
瑞芬太尼%异丙酚%靶控输注%中老年%腹腔镜胆囊手术
瑞芬太尼%異丙酚%靶控輸註%中老年%腹腔鏡膽囊手術
서분태니%이병분%파공수주%중노년%복강경담낭수술
Remifentanil%Propofol%Target controlled infusion%Middle-aged and elderly patients%Laparo-scopic cholecystectomy
目的：探讨瑞芬太尼复合异丙酚靶控输注在中老年腹腔镜胆囊切除术麻醉中的应用效果。方法选取本院2011年1月~2014年12月择期行腹腔镜胆囊切除术的240例患者作为研究对象，随机分为Ⅰ组和Ⅱ组，各120例。Ⅰ组采用瑞芬太尼和异丙酚行靶控输注，Ⅱ组采用芬太尼和异丙酚。观察两组麻醉诱导、气管插管及拔管期的收缩压(SBP)、舒张压(DBP)、心率(HR)及术中血流动力学指标水平，比较两组术毕停止输注后的自主呼吸恢复时间、呼之睁眼时间、拔管时间、定向力恢复时间及疼痛、恶心、呕吐等不良反应发生率。结果Ⅰ组插管后即刻的SBP、DBP、HR水平显著低于Ⅱ组，差异有统计学意义(P<0.01)。Ⅰ组插管后5 min、手术后5 min的SBP、DBP水平显著低于Ⅱ组，差异有统计学意义(P<0.05)。Ⅰ组术后的自主呼吸恢复时间、呼之睁眼时间、拔管时间、定向力恢复时间显著短于Ⅱ组，差异有统计学意义(P<0.05)。两组的头痛、恶心、呕吐发生率比较，差异无统计学意义(P>0.05)。结论瑞芬太尼复合异丙酚靶控输注在中老年腹腔镜胆囊切除术中的应用效果显著，麻醉诱导平稳，术中血流动力学稳定，术后恢复迅速，苏醒完全。
目的：探討瑞芬太尼複閤異丙酚靶控輸註在中老年腹腔鏡膽囊切除術痳醉中的應用效果。方法選取本院2011年1月~2014年12月擇期行腹腔鏡膽囊切除術的240例患者作為研究對象，隨機分為Ⅰ組和Ⅱ組，各120例。Ⅰ組採用瑞芬太尼和異丙酚行靶控輸註，Ⅱ組採用芬太尼和異丙酚。觀察兩組痳醉誘導、氣管插管及拔管期的收縮壓(SBP)、舒張壓(DBP)、心率(HR)及術中血流動力學指標水平，比較兩組術畢停止輸註後的自主呼吸恢複時間、呼之睜眼時間、拔管時間、定嚮力恢複時間及疼痛、噁心、嘔吐等不良反應髮生率。結果Ⅰ組插管後即刻的SBP、DBP、HR水平顯著低于Ⅱ組，差異有統計學意義(P<0.01)。Ⅰ組插管後5 min、手術後5 min的SBP、DBP水平顯著低于Ⅱ組，差異有統計學意義(P<0.05)。Ⅰ組術後的自主呼吸恢複時間、呼之睜眼時間、拔管時間、定嚮力恢複時間顯著短于Ⅱ組，差異有統計學意義(P<0.05)。兩組的頭痛、噁心、嘔吐髮生率比較，差異無統計學意義(P>0.05)。結論瑞芬太尼複閤異丙酚靶控輸註在中老年腹腔鏡膽囊切除術中的應用效果顯著，痳醉誘導平穩，術中血流動力學穩定，術後恢複迅速，囌醒完全。
목적：탐토서분태니복합이병분파공수주재중노년복강경담낭절제술마취중적응용효과。방법선취본원2011년1월~2014년12월택기행복강경담낭절제술적240례환자작위연구대상，수궤분위Ⅰ조화Ⅱ조，각120례。Ⅰ조채용서분태니화이병분행파공수주，Ⅱ조채용분태니화이병분。관찰량조마취유도、기관삽관급발관기적수축압(SBP)、서장압(DBP)、심솔(HR)급술중혈류동역학지표수평，비교량조술필정지수주후적자주호흡회복시간、호지정안시간、발관시간、정향력회복시간급동통、악심、구토등불량반응발생솔。결과Ⅰ조삽관후즉각적SBP、DBP、HR수평현저저우Ⅱ조，차이유통계학의의(P<0.01)。Ⅰ조삽관후5 min、수술후5 min적SBP、DBP수평현저저우Ⅱ조，차이유통계학의의(P<0.05)。Ⅰ조술후적자주호흡회복시간、호지정안시간、발관시간、정향력회복시간현저단우Ⅱ조，차이유통계학의의(P<0.05)。량조적두통、악심、구토발생솔비교，차이무통계학의의(P>0.05)。결론서분태니복합이병분파공수주재중노년복강경담낭절제술중적응용효과현저，마취유도평은，술중혈류동역학은정，술후회복신속，소성완전。
Objective To explore the application effect of remifentanil combined with propofol target controlled infusion in laparoscopic cholecystectomy of middle-aged and elderly patients. Methods 240 patients underwent elective laparo-scopic cholecystectomy from January 2011 to December 2014 in our hospital were selected and randomly divided into groupⅠand group II,120 cases in each group.The group Ⅰ was given remifentani combined with propofol target con-trolled infusion,the group II was given fentany and propofol.The level of systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR) and the index of hemodynamics in period of anesthesia induction,endotracheal intuba-tion and extubation in two groups was observed,The time of spontaneous breathing recovery,opening eyes time on call-ing,extubation time,orientation recovery time and the incidence rate of pain,nausea and vomiting in two groups was compared respectively. Results The level of SBP,DBP and HR in groupⅠ immediately after intubation was lower than that in groupII,with significant difference (P<0.01).The level of SBP,DBP in groupⅠ at 5 minutes after intubation and 5 minutes after operation was lower than that in group II,with significant difference (P<0.05).The time of spontaneous breathing recovery,opening eyes time on calling,extubation time,orientation recovery time after operation in groupⅠ was shorter than that in group II,with significant difference (P<0.05).There was no significant difference in the incidence rate of pain,nausea and vomiting between two groups (P>0.05). Conclusion The application effect of remifentanil com-bined with propofol target controlled infusion in laparoscopic cholecystectomy of middle-aged and elderly patients is significant,the induction of anesthesia and the hemodynamics is stable,the postoperative recovery is quick and the re-suscitation is complete.
