七氟醚静吸复合麻醉在腹腔镜胆囊切除术中的应激反应
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作者:陈繁荣 郑映红
摘 要 目的：探七氟醚静吸复合麻醉在腹腔镜胆囊切除术中的应激反应。方法：纳入2019年4月至2021年4月接诊的60例行腹腔镜胆囊切除术患者，按照随机数字表对照法分为观察组和对照组各30例。观察组麻醉方式为七氟醚静吸复合麻醉，对照组为丙泊酚靶控输注复合麻醉。比较麻醉诱导前10 min（T1）、麻醉诱导后10 min（T2）、气腹建立后30 min（T3）、术后30 min（T4）两组患者血流动力学和应激反应指标的变化情况。结果：观察组T2时刻心率（HR）、平均动脉压（MAP）检测结果均高于对照组，T3时刻HR、MAP检测结果均低于对照组，组间差异有统计学意义（P<0.05）。观察组T2、T3、T4时刻皮质醇（Cor）检测结果均低于对照组，T2、T3、T4时刻去甲肾上腺素（NE）检测结果均高于对照组，组间差异有统计学意义（P<0.05）。结论：腹腔镜胆囊切除术中应用七氟醚静吸复合麻醉血流动力学波动小，能够减轻患者的应激反应，值得临床推荐。
关键词 腹腔镜胆囊切除术；七氟醚静吸复合麻醉；血流动力学指标；应激反应
中图分类号：R657.42 文献标志码：A 文章编号：1006-1533（2022）14-0026-04
引用本文 陈繁荣， 郑映红. 七氟醚静吸复合麻醉在腹腔镜胆囊切除术中的应激反应[J]. 上海医药， 2022， 43（14）： 26-29.
Stress response of sevoflurane intravenous inhalation combined anesthesia in laparoscopic cholecystectomy
CHEN Fanrong， ZHENG Yinghong
（Department of Anesthesiology of Traditional Chinese Medicine Hospital of Jinxi County， Fuzhou， Jiangxi 344800， China）
ABSTRACT Objective： To investigate the stress response of sevoflurane intravenous inhalation combined anesthesia in laparoscopic cholecystectomy. Methods： Sixty patients who underwent laparoscopic cholecystectomy from April 2019 to April 2021 were included， and according to the random number table control method， divided into an observation group and a control group with 30 cases each. The anesthesia mode of the observation group was sevoflurane intravenous inhalation combined anesthesia， and the anesthesia mode of the control group was propofol target controlled infusion combined anesthesia. The changes of hemodynamic indexes and stress response indexes were compared between the two groups 10 minutes before anesthesia induction（T1）， 10 minutes after anesthesia induction（T2）， 30 minutes after pneumoperitoneum establishment（T3） and 30 minutes after operation（T4）. Results： The results of heart rate（HR） and mean arterial pressure（MAP） at T2 in the observation group were higher than those in the control group， and the results of HR and MAP at T3 were lower than those in the control group， and the difference between groups was statistically significant（P<0.05）. The cortisol（COR） test results in the observation group at T2， T3 and T4 were lower than those in the control group， and the detection results of norepinephrine（NE） at T2， T3 and T4 in the observation group were higher than those in the control group， and the difference between the groups was statistically significant（P<0.05）. Conclusion： The application of sevoflurane intravenous inhalation combined anesthesia in laparoscopic cholecystectomy has little hemodynamic fluctuation， and can reduce the stress response of patients， which is worthy of clinical recommendation.
nlc202208181452
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