narcotrend监测在高血压患者腹腔镜胆囊切除手术中的应用.docVIP

精品论文 参考文献 Narcotrend监测在高血压患者腹腔镜胆囊切除手术中的应用 秦　旭 　　四川省凉山州第一人民医院麻醉科　四川　凉山　６１５０００ 　　【摘要】　目的　探讨Narcotrend监测在高血压腹腔镜胆囊切除手术中的应用.方法　选择６０例接受腹腔镜胆囊切除术的高血压患者作为研究对象,将其随机分为对照组和观察组,每组３０例.麻醉方法为静脉全麻,诱导用药为咪唑安定、舒芬太尼、依托咪酯、罗库溴铵,维持用药丙泊酚,瑞芬太尼静脉持续泵注(不选择哮喘患者作为研究对象),根据手术时间间断推注阿曲库铵.对照组患者接受常规监测,观察组患者进行麻醉深度监测,比较两组患者入室(T０)、插管前(T１)、插管后(T２)、出室(T３)时的平均动脉压、心率并记录观察组NT指数,记录两组患者手术后睁眼时间、拔管时间和定位功能恢复时间,比较两组患者的麻醉用药量以及并发症情况.结果　观察组患者的心率、平均动脉压与对照组相比更加稳定(P＜０．０５);观察组患者睁眼时间和定位恢复时间显著短于对照组患者(P＜０．０５);观察组患者丙泊酚用量显著少于对照组(P＜０．０５),其余药物剂量无明显差异(P＞０．０５);两组患者术后并发症发生情况无显著差异(P＞０．０５).结论　Narcotrend(NT)监测应用于高血压患者腹腔镜胆囊切除术对患者的心率、平均动脉压等具有更好的稳定作用,明显缩短患者的苏醒时间,提高手术的安全性,值得临床推广使用. 【关键词】　高血压;　腹腔镜胆囊切除术;　Narcotrend监测【Abstract】　Objective:ToinvestigatetheapplicationofNarcotrendinthelaparoscopiccholecystectomyinhighbloodpressure．Methods:６０patientswithhypertensionwererandomlydividedintocontrolgroupandobservationgroup,３０casesineachgroup．Anesthesiamethodforintravenousanesthesia,inductionofmedicationmidazolamandfentanyl,etomidate,rocuronium,maintenancedoseofpropofol,remifentanilintravenouscontinuousinfusion(notchoseninasthmapatientsastheresearchobject),accordingtotheoperationtimebyintermittentbolusinjectionofatracurium．PatientsinthecontrolgroupreceivedroutinemoniＧtoring,patientsintheobservationgroupweremonitoringthedepthofanesthesia,werecomparedbetweenthetwogroups(T０),beforeintubation(T１),afterinＧtubation(T２),room (T３),meanarterialpressure,heartrateandrecordtheobservationgroupNTindex,wererecordedaftersurgeryinbothgroupsofpatientswithopeneyestime,drawingtubetimeandpositioningfunctionrecoverytime,comparedtwogroupsofpatientswithanesthesiadosageandcomplications．ReＧsults:observationgroupofpatientswithheartrate,meanarterialpressurecomparedwiththecontrolgroup(P ＜ ０．０５)ofthemorestable;observationgroupwereeyeopeningtimeandlocationofrecoverytimewassignificantlyshorterthanthatofthecontrolgroup(P＜０．０５);theobservationamountofpatientsinthepropofolgroupweresignificantlylessthanthatofthecontrolgroup(P＜０．０５)andtherestofthedrugdosenosignificantdifference(P＞０．０５);tw