CAJ | 학술논문

目的：探讨瑞芬太尼复合丙泊酚用于腹腔镜胆囊切除术的麻醉效果。方法选取2013年5月至2014年5月华北石油二部医院收治的120例需行腹腔镜胆囊切除术患者为研究对象，完全随机分为瑞芬太尼组和芬太尼组，各60例。瑞芬太尼组给予瑞芬太尼复合丙泊酚麻醉，芬太尼组给予芬太尼复合丙泊酚麻醉，对比两组患者的麻醉效果。结果瑞芬太尼组与芬太尼组的收缩压、舒张压及心率在术前和术毕的组内及组间比较，差异无统计学意义（ P＞0.05），但是在气腹后瑞芬太尼组的收缩压、舒张压及心率显著低于芬太尼组，差异有统计学意义（ P ＜0.05）。瑞芬太尼组的意识恢复时间为（7.9±2.2） min，拔管时间为（14.8±2.8） min，止痛时间为（16.9±2.5） min，显著低于芬太尼组的意识恢复时间（11.3±2.1） min，拔管时间（18.9±2.4） min，止痛时间（23.2±3.1） min（P ＜0.01）；瑞芬太尼组的综合VAS评分为（1.8±1.0）分，芬太尼组为（4.3±1.1）分，瑞芬太尼组显著低于芬太尼组，差异有统计学意义（P＜0.01）。术后24 h不良反应主要包括恶心呕吐、呼吸抑制、嗜睡及苏醒后躁动，瑞芬太尼组总不良反应发生率低于芬太尼组[3.3％（2／60）比23.3％（14／60）]，差异有统计学意义（ P＜0.05）；瑞芬太尼组无呼吸抑制及躁动情况发生，而芬太尼组呼吸抑制发生率为3.4％，躁动率为5.1％，两组比较差异有统计学意义（ P＜0.05）。结论瑞芬太尼复合丙泊酚用于腹腔镜胆囊切除术的麻醉效果好，安全性高，值得临床应用。
목적：탐토서분태니복합병박분용우복강경담낭절제술적마취효과。방법선취2013년5월지2014년5월화북석유이부의원수치적120례수행복강경담낭절제술환자위연구대상，완전수궤분위서분태니조화분태니조，각60례。서분태니조급여서분태니복합병박분마취，분태니조급여분태니복합병박분마취，대비량조환자적마취효과。결과서분태니조여분태니조적수축압、서장압급심솔재술전화술필적조내급조간비교，차이무통계학의의（ P＞0.05），단시재기복후서분태니조적수축압、서장압급심솔현저저우분태니조，차이유통계학의의（ P ＜0.05）。서분태니조적의식회복시간위（7.9±2.2） min，발관시간위（14.8±2.8） min，지통시간위（16.9±2.5） min，현저저우분태니조적의식회복시간（11.3±2.1） min，발관시간（18.9±2.4） min，지통시간（23.2±3.1） min（P ＜0.01）；서분태니조적종합VAS평분위（1.8±1.0）분，분태니조위（4.3±1.1）분，서분태니조현저저우분태니조，차이유통계학의의（P＜0.01）。술후24 h불량반응주요포괄악심구토、호흡억제、기수급소성후조동，서분태니조총불량반응발생솔저우분태니조[3.3％（2／60）비23.3％（14／60）]，차이유통계학의의（ P＜0.05）；서분태니조무호흡억제급조동정황발생，이분태니조호흡억제발생솔위3.4％，조동솔위5.1％，량조비교차이유통계학의의（ P＜0.05）。결론서분태니복합병박분용우복강경담낭절제술적마취효과호，안전성고，치득림상응용。
Objective To investigate the anesthesia effect of remifentanil combined with propofol for laparoscopic cholecystectomy.Methods During May 2013 and May 2014 in Huabei Oilfield Division Two Hospital 120 cases of laparoscopic cholecystectomy were included in the study , and randomly divided into observation group and fentangl group:the remifentanil group received remifentanil plus propofol anesthesia , while the fentangl group received fentanyl and propofol anesthesia ,and the anesthetic effect of the two groups were compared.Results Systolic blood pressure,diastolic blood pressure and heart rate before and after sur-gery and between the two groups had no statistically significant difference(P >0.05) ,but systolic blood pressure,diastolic blood pressure and heart rate after pneumoperitoneum in the remifentanil group were statis-tically significantly lower than the fentangl group(P<0.05).In the remifentanil group consciousness recov-ery time was (7.9 ±2.2) min,extubation time was (14.8 ±2.8) min, analgesic time was (16.9 ±2.5) min, significantly lower than the fentangl group′s (11.3 ±2.1) min,(18.9 ±2.4) min,(23.2 ±3.1) min respectively (P<0.01);the integrated VAS score of he the remifentanil group was (1.8 ±1.0),of the fen-tangl group was (4.3 ±1.1), the difference was statistically significant(P<0.01).The 24 h postoperative adverse reactions included nausea,vomiting,respiratory depression,lethargy, and restlessness after waking, total adverse renction rate of the remifentanil group was lower than the fentangl group [ 3.3% ( 2/60 ) vs 23.3% (14/60)],the difference was satistically significant (P<0.05);there was no breathing depression and restlessness in the remifentanil group, while in the fentangl group was 3.4%and 5.1%respectively,the differences were statistically significant(P <0.05).Conclusion The anesthetic effect of remifentanil and propofol for laparoscopic cholecystectomy is good, with high safety,thus is worthy of clinical application.