舒芬太尼与瑞芬太尼联合麻醉在腹腔镜子宫切除手术中应用.docVIP

舒芬太尼与瑞芬太尼联合麻醉在腹腔镜子宫切除手术中应用 　　[摘要] 目的 探?舒芬太尼与瑞芬太尼联合麻醉对腹腔镜子宫切除手术患者血清一氧化氮（NO）/内皮素-1（ET-1）平衡及血流动力学影响。 方法 将72例择期腹腔镜子宫切除手术患者随机分为联合组和对照组，分别采用舒芬太尼联合瑞芬太尼麻醉及单独瑞芬太尼麻醉。记录两组麻醉诱导前（T1）、诱导后（T2）、插管时（T3）及拔管时（T4）血清NO及ET-1水平、血流动力学变化及不良反应。 结果 对照组T2、T3、T4时HR和MAP与T1时比较均上升（P0.05），且对照组T2、T3、T4时HR和MAP高于同时点联合组（P0.05）。 结论 舒芬太尼与瑞芬太尼联合麻醉用于腹腔镜子宫切除术对血流动力学影响小，安全性较好，作用可能与其可更好维持血清NO/ET-1平衡、改善内皮细胞功能密切相关。 　　[关键词] 腹腔镜子宫切除术；舒芬太尼；瑞芬太尼；一氧化氮；内皮素-1；血流动力学 　　[中图分类号] R614 [文献标识码] B [文章编号] 1673-9701（2018）01-0111-04 　　Application of sufentanil combined with remifentanil in laparoscopic hysterectomy 　　CHEN Qingjuan1 CHEN Jian1 CHEN Hongcai2 　　1.Department of Anesthesiology， Taizhou Enze Medical Center（Group） Taizhou Hospital Affiliated Maternity Hospital in Zhejiang Province， Taizhou 318000， China； 2.Department of Anesthesiology， Taizhou Enze Medical Center（Group） Luqiao Hospital， Taizhou 318050， China 　　[Abstract] Objective To investigate the effect of sufentanil combined with remifentanil on serum nitric oxide（NO）/endothelin-1（ET-1） balance and hemodynamics in patients undergoing laparoscopic hysterectomy. Methods 72 cases of elective laparoscopic hysterectomy were randomly divided into combined group treated with sufentanil combined with remifentanil anesthesia and control group treated with remifentanil alone. The levels of serum NO and ET-1， hemodynamics and adverse reactions in the two groups were recorded before induction（T1）， after induction（T2）， when intubation（T3） and when extubation（T4）. Results The HR and MAP at T2， T3 and T4 were increased compared with those at T1 in the control group（P0.05）. The HR and MAP in the control group were higher than those of the combined group at T2， T3 and T4（P0.05）. Conclusion The sufentanil and remifentanil combined anesthesia for laparoscopic hysterectomy has less effect on hemodynamics and better safety， which may be closely related to the better maintaining of serum NO/ET-1 balance and improvement of endothelial function. 　　[Key words] Laparoscopic hystere