三磷酸腺苷二钠氯化镁对腹腔镜胆囊切除术气腹时血流动力学的影响.docVIP

三磷酸腺苷二钠氯化镁对腹腔镜胆囊切除术气腹时血流动力学的影响 吕 斌 刘远安 云南省曲靖市第二人民医院 麻醉科 655000 【摘要】：目的：研究腹腔镜胆囊切除术气腹时的心血管反应及三磷酸腺苷二钠氯化镁对它的影响。方法：ASA Ⅰ或II级腹腔镜胆囊切除术的病人80例，随机分为三磷酸腺苷二钠氯化镁组（A组）40例，对照组（N组）40例。气腹前1min按照分组静脉滴注相应的药物。结果：气腹后N组BP、HR显著升高（P0.01），A组BP、HR的差异无统计学意义。结论：三磷酸腺苷二钠氯化镁能有效抑制CO2气腹反应，减少芬太尼-丙泊酚的用量。效果确切，使用方便，不良反应小。 【关键词】三磷酸腺苷二钠氯化镁，气腹，腹腔镜胆囊切除术，血流动力学。 Effect of Adenosine Disodium Triphosphate and Magnesium Chloride for Injection on haemodynamics in the patients undergoing laparoscopic cholecystectomy LV bin, Liu Yan-an.Department of Anesthesiology ,Qujing Second People,s Hospital, Qujing 655000, China 【Abstract】：Objective To investigate the effects of Adenosine Disodium Triphosphate and Magnesium Chloride for Injection on haemodynamics in the patients undergoing laparoscopic cholecystectomy .Methods Eighty patients, ASA class Ⅰor II, undergoing laparoscopic cholecystectomy were randomized to two groups with 40 cases each,were randomly divided into Adenosine Disodium Triphosphate and Magnesium Chloride for Injection(A)group,control(N),respectively at 1 min before pneumoperitoneum. Results After pneumoperitoneum,the values of BP and HR were increased significantly in group N（P0.01）,Compared with A,there was no significantly change in BP and HR. Conclusion Adenosine Disodium Triphosphate and Magnesium Chloride for Injection may inhibit pneumoperitoneum response properly during the patients undergoing laparoscopic cholecystectomy，convenient and safe with less side effect in the patients undergoing laparoscopic cholecystectomy. 【Key words】 Adenosine Disodium Triphosphate and Magnesium Chloride for Injection ; Pneumoperitoneum; laparoscopic cholecystectomy; haemodynamics 腹腔镜胆囊切除术有对机体创伤小，术后疼痛轻，恢复快等优点，但是，为创造足够的手术操作空间，需要实施CO2气腹①，CO2气腹可导致机体产生一系列病理生理变化，出现神经内分泌的改变以及血流动力学的波动，表现为心率、血压升高②③， 甚至可能引起威胁生命的并发症③，临床上往往使用阿片药物或丙泊酚抑制气腹所致的反应，但使用丙泊酚加芬太尼会使麻醉过深，苏醒拔管延迟。本研究旨在研究腹腔镜胆囊切除术血流动力学的影响，以及三磷酸腺苷二钠氯化镁使用抑制机体对气腹的反应。