舒芬太尼与瑞芬太尼联合麻醉在腹腔镜子宫切除手术中的应用.docVIP

晞；紺桶关合??竟子朗辟术中 的 2018-03-20 01:26:12中国现代医生2018年1期 陈清娟陈健陈宏才 ［摘要］戸的探討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) /内皮素邛(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吋HR和MAP与T1时比较均上升(P0.05),联合组T2、T3、T4吋 HR和MAP与T1时比较变化不明显(P0.05),且对照组T2、T3、T4时HR和MAP高于同时点 联合组(P0.05) o两组T2、T3、T4时NO及ET-1水平与巧时比较均上升(P0.05),联合组 NO水平上升幅度小于对照组，ET-1水平上升幅度大于对照组(Pv0.05) o两组治疗中共发生药物 不良反应6例，联合组4例，对照组2例，两组差异不明显(X2=0.18, 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和关。 ［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1673-9701 (2018) 01-0111-04 Application of sufentanil combined with remifentanil in laparoscopic hysterectomy CHEN Qingjuard CHEN Jianl CHEN Hongcai2 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) /endotheli(ETbalanee 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 in creased compared with those at T1 in the control group (P0.05) . And the changes of HR and MAP were not significant at T2, T3 and T4 compared with those at T1 in the combined 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