靶控输注异丙酚在门诊无痛人流术中的应用研究.DOCVIP

临床医学论文-靶控输注异丙酚在门诊无痛人流术中的应用研究 【关键词】? 靶控 ??? 摘要：目的：评价靶控输注异丙酚在门诊无痛人流手术中的麻醉效果。方法：90例患者随机分为两组即靶控输注组（E组）和手控输注组（H组），每组45例。分别观察和比较两组的麻醉效能、术中呼吸循环的变化、双频脑电指数（BIS）以及术后不良反应等指标。结果：H组的异丙酚总用量显著高于E组（P0.05），苏醒时间较长，但其诱导时间较短。在注药前、诱导时、术毕时和清醒时两组的心率、血压的差异没有显著性（P0.05），但H组的动脉血氧饱和度在诱导时显著低于E组（P0.05）。各时间点上两组的BIS值之间的差异没有统计学意义(P0.05)，但术后H组的恶心头晕等不良反应率高于E组（P0.05）。结论：靶控输注异丙酚应用于门诊无痛人流手术优于传统的手控输注方法，值得临床推广应用。 ??? 关键词：靶控输注；异丙酚；无痛人流 ??? Study The Effect of Propofol by Target-controlled Infusion(TCI) in Outpatient Artificial Abortion ????? Abstract: Objective: To estimate effect of propofol by target-controlled infusion(TCI) in outpatient artificial abortion. Method: 90 patients were randomly divided into two group: group E(target-controlled infusion) and group H(hand-controlled infusion). Each group is 45 cases. Effectiveness of narcosis, change of respiration and circulation, BIS and side-effect of operation were observed and recorded. Result: Total amount of propofol used in group H was significantly more than group E（P0.05）. The recovery time in group H was more longer but the induced time in group H was more shorter. There were not significantly different in heart rate and blood pressure in operation process between two group（P0.05）. SpO2 was significantly lower in group H than in group E（P0.05）. There was no significant difference in BIS values between the two groups(P0.05). There were much more side-effect of operation in group? H than in group E（P0.05）. Conclusion: Target-controlled infusion of propofol had a better effect in outpatient artificial abortion than hand-controlled infusion and could be widely applied. ??? Key words:TCI;Propofol;Artificial abortion ??? 异丙酚是门诊无痛人流手术中广泛使用的麻醉药，目前大多数医院主要使用手控输注的方法来进行麻醉，这种方法有用药量和麻醉深度不易控制等缺点。靶控输注（target controlled infusion, TCI）能够通过计算机准确设定手术过程当中的给药浓度，可控性非常好。本研究通过比较靶控输注异丙酚与手控输注异丙酚在门诊无痛人流手术中的麻醉效果，评价靶控输注异丙酚在门诊无痛人流手术中的应用价值。 ??? 1对象与方法 ??? 1.1研究对象选择：90例早孕患者来自于本院的就医者，按就医时间的先后随机分为两组：靶控输注组（E组）和手控输注组（H组）。病例的纳入标准为：孕期在60d以内，美国麻醉协会（ASA）Ⅰ级，年龄在18～40岁，术前检查无呼吸，循环系统疾病。 ??? 1