三种剂量地佐辛用于腹腔镜子宫切除手术麻醉诱导对患者循环和应激反应影响的比较研究
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摘要
目的比较3种剂量地佐辛用于腹腔镜子宫切除手术麻醉诱导对患者循环和应激反应的影响。方法选取2016年1月—2018年1月于梧州市红十字会医院行腹腔镜子宫切除手术治疗患者120例,随机分为A、B、C组及对照组,各30例。A组患者于术前静脉注射地佐辛0.1 mg/kg,B组患者为0.2 mg/kg,C组为0.3 mg/kg,对照组为0.9%氯化钠溶液2 ml。比较4组患者麻醉前、术后1 h、术后1 d应激反应指标〔丙二醛(MDA)、超氧化物歧化酶(SOD)〕、视觉模拟评分法(VAS)评分及血流动力学指标〔平均动脉压(MAP)、心率(HR)〕。结果麻醉前,4组患者MDA、SOD、VAS评分、MAP、HR比较,差异无统计学意义(P>0.05);术后1 h、1 d,B组患者MDA、SOD、VAS评分、MAP、HR低于其他3组(P<0.05)。结论 3种剂量地佐辛用于腹腔镜子宫切除手术麻醉诱导均可发挥一定的镇静和镇痛效果,但0.2 mg/kg地佐辛对患者循环和应激反应影响更小。
Objective To compare the influence of three doses of dizocine on circulation and stress response to anesthesia induction in laparoscopic hysterectomy.Methods A total of 120 cases of patients with laparoscopic hysterectomy were selected from January 2016 to January 2018 in Wuzhou Red Cross Hospital,which were randomly divided into A,B,C and control groups,30 cases each of group.Group A received intravenous injection of desoxacin 0.1 mg/kg before operation,Group B 0.2 mg/kg,group C 0.3 mg/kg,the control group was 0.9% sodium chloride solution 2 ml.The MDA、SOD、VAS score、MAP and HR before anesthesia,after operation of 1 hour and 1 day were compared among the four groups.Results Before anesthesia,there was no significant differences in MDA,SOD,VAS score or MAP,HR among the four groups(P>0.05);after operation of 1 hour and 1 day,the MDA,SOD,VAS score and MAP,HR in group B were lower than other three groups(P<0.05).Conclusion Three doses of dizocine can be used to induce anesthesia in laparoscopic hysterectomy,all of them have certain sedative and analgesic effects,however 0.2 mg/kg dizocine have less effect on circulation and stress response.
Objective To compare the influence of three doses of dizocine on circulation and stress response to anesthesia induction in laparoscopic hysterectomy.Methods A total of 120 cases of patients with laparoscopic hysterectomy were selected from January 2016 to January 2018 in Wuzhou Red Cross Hospital,which were randomly divided into A,B,C and control groups,30 cases each of group.Group A received intravenous injection of desoxacin 0.1 mg/kg before operation,Group B 0.2 mg/kg,group C 0.3 mg/kg,the control group was 0.9% sodium chloride solution 2 ml.The MDA、SOD、VAS score、MAP and HR before anesthesia,after operation of 1 hour and 1 day were compared among the four groups.Results Before anesthesia,there was no significant differences in MDA,SOD,VAS score or MAP,HR among the four groups(P>0.05);after operation of 1 hour and 1 day,the MDA,SOD,VAS score and MAP,HR in group B were lower than other three groups(P<0.05).Conclusion Three doses of dizocine can be used to induce anesthesia in laparoscopic hysterectomy,all of them have certain sedative and analgesic effects,however 0.2 mg/kg dizocine have less effect on circulation and stress response.
引文
[1]杨晓瑞,葛静,周迪兰.七氟醚或丙泊酚复合瑞芬太尼麻醉在腹腔镜子宫切除术中的应用及对患者应激反应的影响[J].临床和实验医学杂志,2015,13(5):423-426.
[2]贺红英,李力,陈江鸿,等.腹腔镜子宫切除术治疗妇科良性疾病疗效的系统评价[J].中国循证医学杂志,2013,13(1):62-69.
[3]谢秋娴,杨纯,谢昭雄,等.腹腔镜子宫肌瘤剥除术和腹腔镜次全子宫切除术对患者卵巢功能及其性功能的影响[J].中国性科学,2015,24(4):3-5.
[4]FINDLEY A D,SIEDHOFF M T,HOBBS K A,et al.Short-term effects of salpingectomy during laparoscopic hysterectomy on ovarian reserve:a pilot randomized controlled trial[J].Fertility&Sterility,2013,100(6):1704-1708.
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[6]MCGOVERN P G,JR L M,MARTINO M A.Comparison of robotic and laparoscopic hysterectomy for benign gynecologic disease[J].Obstetrics&Gynecology,2014,122(4):778-786.
[7]郝伟,王鹏,单世民.全身麻醉复合硬膜外麻醉与静吸复合全身麻醉在腹腔镜子宫切除术中应用的效果比较[J].中国现代医学杂志,2014,24(36):97-100.
[8]邓默.右旋美托咪啶复合瑞芬太尼静脉麻醉在腹腔镜子宫切除术中的效果观察[J].解放军医药杂志,2014,26(11):85-88.
[9]赵琳,章燕,岑建文.地佐辛联合罗哌卡因超前镇痛在腹腔镜子宫切除术后镇痛的应用[J].医学综述,2013,19(11):2094-2096.
[10]姚昌银,童生元.全麻联合硬膜外阻滞对腹腔镜子宫切除术患者应激反应的影响[J].蚌埠医学院学报,2015,40(2):174-176.
[11]汪胜友,金文然,王丽.地佐辛、喷他佐辛用于腹腔镜子宫切除术后自控静脉镇痛的临床观察[J].蚌埠医学院学报,2014,39(2):202-206.
[12]朱学芳,杜娟,陈金红,等.腹腔镜子宫切除术不同气腹压力下PaCO2和PETCO2的变化及其相关性[J].临床麻醉学杂志,2015,31(10):1029-1030.
[13]LIU C,SONG X,WU S.Effects of dexmedetomidine on the quality of recovery in patients undergoing laparoscopic hysterectomy[J].Medical Journal of Wuhan University,2014,35(2):321-324.
[14]刘明,王玮.地佐辛用于腹腔镜子宫切除术麻醉效果观察[J].陕西医学杂志,2016,45(1):87-88.
[15]钱宁,朱根勤,费杭模.地佐辛用于腹腔镜子宫切除手术麻醉诱导及剂量探究[J].现代中西医结合杂志,2017,26(26):2948-2951.
[2]贺红英,李力,陈江鸿,等.腹腔镜子宫切除术治疗妇科良性疾病疗效的系统评价[J].中国循证医学杂志,2013,13(1):62-69.
[3]谢秋娴,杨纯,谢昭雄,等.腹腔镜子宫肌瘤剥除术和腹腔镜次全子宫切除术对患者卵巢功能及其性功能的影响[J].中国性科学,2015,24(4):3-5.
[4]FINDLEY A D,SIEDHOFF M T,HOBBS K A,et al.Short-term effects of salpingectomy during laparoscopic hysterectomy on ovarian reserve:a pilot randomized controlled trial[J].Fertility&Sterility,2013,100(6):1704-1708.
[5]阮立勤.腹腔镜子宫切除术与传统子宫切除术的临床效果探讨[J].河北医学,2013,19(3):413-415.
[6]MCGOVERN P G,JR L M,MARTINO M A.Comparison of robotic and laparoscopic hysterectomy for benign gynecologic disease[J].Obstetrics&Gynecology,2014,122(4):778-786.
[7]郝伟,王鹏,单世民.全身麻醉复合硬膜外麻醉与静吸复合全身麻醉在腹腔镜子宫切除术中应用的效果比较[J].中国现代医学杂志,2014,24(36):97-100.
[8]邓默.右旋美托咪啶复合瑞芬太尼静脉麻醉在腹腔镜子宫切除术中的效果观察[J].解放军医药杂志,2014,26(11):85-88.
[9]赵琳,章燕,岑建文.地佐辛联合罗哌卡因超前镇痛在腹腔镜子宫切除术后镇痛的应用[J].医学综述,2013,19(11):2094-2096.
[10]姚昌银,童生元.全麻联合硬膜外阻滞对腹腔镜子宫切除术患者应激反应的影响[J].蚌埠医学院学报,2015,40(2):174-176.
[11]汪胜友,金文然,王丽.地佐辛、喷他佐辛用于腹腔镜子宫切除术后自控静脉镇痛的临床观察[J].蚌埠医学院学报,2014,39(2):202-206.
[12]朱学芳,杜娟,陈金红,等.腹腔镜子宫切除术不同气腹压力下PaCO2和PETCO2的变化及其相关性[J].临床麻醉学杂志,2015,31(10):1029-1030.
[13]LIU C,SONG X,WU S.Effects of dexmedetomidine on the quality of recovery in patients undergoing laparoscopic hysterectomy[J].Medical Journal of Wuhan University,2014,35(2):321-324.
[14]刘明,王玮.地佐辛用于腹腔镜子宫切除术麻醉效果观察[J].陕西医学杂志,2016,45(1):87-88.
[15]钱宁,朱根勤,费杭模.地佐辛用于腹腔镜子宫切除手术麻醉诱导及剂量探究[J].现代中西医结合杂志,2017,26(26):2948-2951.