摘要
目的为避免患者术中出现应激反应,探究瑞芬太尼与丙泊酚复合用于腹腔镜胆囊切除术的麻醉效果。方法以2015年9月~2016年10月期间入我院进行腹腔镜胆囊切除术治疗的110例患者为研究对象,将患者采用双盲法平均分为一般、观察两组,每组各55例。其中一般组术中以丙泊酚维持麻醉,治疗组术中麻醉维持采用瑞芬太尼与丙泊酚复合,观察气腹后、拔管时患者血流动力学变化情况,比较两组术后疼痛、恢复状况,统计手术不良反应情况。结果一般组患者较治疗组意识恢复、拔管时间用时长,术后疼痛感强、术中镇静差,差异有统计学意义(P<0.05)。两组不良反应发生率比较,治疗组为5.5%明显低于一般组14.5%,治疗组手术安全性高,差异有统计学意义(P<0.05)。气腹后、拔管时两组患者血氧饱和度变化差异有统计学意义(P>0.05)。气腹后、拔管时治疗组患者较一般组患者血压、心率波动平稳,差异有统计学意义(P<0.05)。结论临床行腹腔镜胆囊切除术时,以瑞芬太尼与丙泊酚复合麻醉,患者麻醉效果好,能保持血液流动学相对平稳。
Objective To explore the anesthetic effect of remifentanil combined with propofol in laparoscopic cholecystectomy in order to avoid stress reaction during operation. Methods One hundred and ten patients admitted to our hospital for laparoscopic cholecystectomy from September 2015 to October 2016 were selected as the subjects.The patients were divided into general group and observation group by double blind method,with 55 cases in each group.Propofol was used to maintain anesthesia in the general group while remifentanil and propofol were used to maintain anesthesia in the treatment group.The hemodynamic changes of patients after pneumoperitoneum and extubation were observed,the postoperative pain and recovery status of the two groups were compared, and the adverse reactions of the operation were counted. Results Patients in general group had longer recovery time and longer extubation time than those in treatment group.Postoperative pain was strong and intraoperative sedation was poor,P < 0.05.Compared with the incidence of adverse reactions in the two groups,5.5% in the treatment group was significantly lower than 14.5 % in the general group,and the operation safety in the treatment group was high,P < 0.05.There was no significant difference in blood oxygen saturation between the two groups after pneumoperitoneum and extubation,P > 0.05.After the pneumoperitoneum and extubation,the blood pressure and heart rate of the patients in the treatment group were more stable than those in the general group,P < 0.05. Conclusion In clinical laparoscopic cholecystectomy, remifentanil and propofol combined anesthesia,which has good anesthesia effect and can keep blood flow relatively stable.
引文
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