不同丙泊酚制剂麻醉对高脂血症患者围术期血脂水平影响.docVIP

不同丙泊酚制剂麻醉对高脂血症患者围术期血脂水平的影响 　　[摘要] 目的 探讨高血脂患者应用不同丙泊酚制剂手术麻醉对其围手术期血脂水平的影响。 方法 方便选取2014年1月―2015年12月收治的高脂血症手术患者90例，随机分3组，各30例，A组采用吸入七氟醚维持全麻，B组使用规格为50 mL/500 mg的长链脂肪酸，C组使用规格为20 mL/200mg的中长链脂肪酸，比较各组在围手术期的血脂水平变化。结果 各组手术后血脂水平较T0时均有明显变化，B、C两组在T1时LDL值和TC值均有明显下降，C组下降幅度B组；比较差异有统计学意义（P0.05）；T2时B、C两组TG水平明显下降；T3时B组HDL值明显上升。 结论 丙泊酚长链脂肪酸对患者围手术期的血脂水平变化影响较小，为高血脂症患者手术麻醉的更为安全的选择。 　　[关键词] 丙泊酚；高脂血症；长链脂肪酸；中长链脂肪酸 　　[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2016）05（c）-0120-02 　　[Abstract] Objective To study the effect of different propofol anesthesia on blood lipid level in perioperative period in patients with hyperlipemia. Methods 90 cases of patients with hyperlipemia operation admitted and treated from January 2014 to December 2015 were selected and randomly divided into three groups with 30 cases in each， the group A adopted sevoflurane for general anesthesia maintenance， the group B adopted 50 mL/500 mg long chain fatty acid， the group C adopted 20ml/200mg moderate and long chain fatty acid， and the changes of blood lipid level in perioperative period of each group were compared. Results There were obvious changes of blood lipid levels in each group after operation compared with those at the time of T0， the LDL value and TC value in the group B and group C obviously decreased at the time of T1， and the decrease range in the group C was bigger than that in the group B， and the difference had statistical significance by comparison， P0.05， the TG levels in the group B and group C obviously decreased at the time of T2， and the HDL value in the group B obviously increased at the time of T3. Conclusion The effect of propofol long-chain fatty acid on the changes of blood lipid level in perioperative period is smaller， and it is a safer choice of operative anesthesia for patients with hyperlipemia. 　　[Key words] Propofol； Hyperlipemia； Long chain fatty acid； Moderate and long chain fatty acid 　　丙泊酚因其具有麻醉诱导快、术后苏醒迅速和不良反应少，被广泛应用于各种临床麻醉中，并取得良好的麻醉效果。过剂量应用丙泊酚有增加甘油三脂水平、导致肝功能减退，使机体脂肪负荷加重和代谢紊乱的可能，影响血