瑞芬太尼复合丙泊酚用于腹腔镜胆囊切除术的麻醉效果观察
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摘要
目的观察行腹腔镜胆囊切除术时应用瑞芬太尼复合丙泊酚麻醉的效果。方法选取医院收治的腹腔镜胆囊切除术患者86例进行回顾性分析,其中41例行芬太尼+丙泊酚麻醉者作为甲组,45例行瑞芬太尼+丙泊酚麻醉者作为乙组。观察比较2组不同时段的血流动力学变化(HR,SBP,Sp O2),应激指标(COGT和CPR)以及麻醉苏醒情况(自主呼吸时间,睁眼时间,拔管时间及定向力恢复时间)等。结果气腹后至术毕,乙组血流动力学指标、应激指标水平均优于甲组(P <0. 01);乙组术后麻醉苏醒相关的各项指标的所用的时长均短于甲组(P <0. 01)。结论腹腔镜胆囊切除术麻醉中,瑞芬太尼复合丙泊酚麻醉方案对血流动力学影响小,抗应激作用显著,且术后恢复快,值得推广应用。
Objective To observe the anesthetic effect of remifentanil combined with propofol in laparoscopic cholecystectomy. Methods The clinical data of 86 patients who underwent laparoscopic cholecystectomy were retrospectively analyzed. 41 patients received fentanyl combined with propofol anesthesia as group A,45 patients received remifentanil combined with propofol anesthesia as group B. The hemodynamic changes( HR,SBP,Sp O2),stress index( COGT and CPR) and anesthesia recovery( spontaneous breathing time,eye opening time,extubation time and orientation recovery time) were observed and compared between the two groups. Results From the establishment of pneumoperitoneum to the end of operation,the changes of hemodynamics and stress indexes in group B were better than those in family( P < 0. 01),and the duration of anesthesia recovery related indexes in group B was shorter than that in group A( P < 0. 01). Conclusion Remifentanil combined with propofol anesthesia for laparoscopic cholecystectomy has less impact on hemodynamics,significant anti-stress effect,and rapid recovery after operation,which is worthy of clinical application.
Objective To observe the anesthetic effect of remifentanil combined with propofol in laparoscopic cholecystectomy. Methods The clinical data of 86 patients who underwent laparoscopic cholecystectomy were retrospectively analyzed. 41 patients received fentanyl combined with propofol anesthesia as group A,45 patients received remifentanil combined with propofol anesthesia as group B. The hemodynamic changes( HR,SBP,Sp O2),stress index( COGT and CPR) and anesthesia recovery( spontaneous breathing time,eye opening time,extubation time and orientation recovery time) were observed and compared between the two groups. Results From the establishment of pneumoperitoneum to the end of operation,the changes of hemodynamics and stress indexes in group B were better than those in family( P < 0. 01),and the duration of anesthesia recovery related indexes in group B was shorter than that in group A( P < 0. 01). Conclusion Remifentanil combined with propofol anesthesia for laparoscopic cholecystectomy has less impact on hemodynamics,significant anti-stress effect,and rapid recovery after operation,which is worthy of clinical application.
引文
[1]黎达锋,曾秋谷,梁华娜,等.瑞芬太尼复合丙泊酚麻醉对腹腔镜胆囊切除术中血流动力学的影响[J].医学综述,2014,20(14):2666-2668. DOI:10. 3969/j. issn. 1006-2084. 2014. 14. 070.
[2]蒋艳东,赵素敏.瑞芬太尼联合丙泊酚麻醉对腹腔镜胆囊切除术患者应激反应、血气指标的影响[J].海南医学院学报,2016,22(7):677-679. DOI:10. 13210/j. cnki. jhmu. 20160108. 010.
[3]马玉洋,李全,刘进德.瑞芬太尼复合丙泊酚用于腹腔镜胆囊切除术的麻醉效果分析[J].医学综述,2015,21(18):3449-3451.DOI:10. 3969/j. issn. 1006-2084. 2015. 18. 072.
[4]刘志松,尹洪峰,刘晓飞,等.瑞芬太尼复合丙泊酚用于腹腔镜胆囊切除术的麻醉效果观察[J].中国现代医生,2013,51(32):107-108.
[5]王建设,丛静.腹腔镜胆囊切除术中应用瑞芬太尼复合丙泊酚静脉麻醉的效果分析[J].国际医药卫生导报,2016,22(1):86-88.DOI:10. 3760/cma. j. issn. 1007-1245. 2016. 01. 030.
[6]王怀彬.瑞芬太尼复合丙泊酚麻醉对腹腔镜胆囊切除术中血流动力学的影响[J].河南外科学杂志,2016,22(6):115-116.
[7]王永强,杨晓.瑞芬太尼复合丙泊酚用于腹腔镜胆囊切除术的麻醉效果探讨[J].基层医学论坛,2017,21(22):2940-2941. DOI:10. 19435/j. 1672-1721. 2017. 22. 039.
[8]孙功耀.研究瑞芬太尼复合丙泊酚用于腹腔镜胆囊切除术的麻醉效果[J].实用中西医结合临床,2017,17(5):73-74. DOI:10.13638/j. issn. 1671-4040. 2017. 05. 046.
[9]徐明霞.瑞芬太尼和舒芬太尼分别复合丙泊酚静脉麻醉对腹腔镜胆囊切除术患者心血管应激的影响[J].河南外科学杂志,2017,23(5):59-61.
[2]蒋艳东,赵素敏.瑞芬太尼联合丙泊酚麻醉对腹腔镜胆囊切除术患者应激反应、血气指标的影响[J].海南医学院学报,2016,22(7):677-679. DOI:10. 13210/j. cnki. jhmu. 20160108. 010.
[3]马玉洋,李全,刘进德.瑞芬太尼复合丙泊酚用于腹腔镜胆囊切除术的麻醉效果分析[J].医学综述,2015,21(18):3449-3451.DOI:10. 3969/j. issn. 1006-2084. 2015. 18. 072.
[4]刘志松,尹洪峰,刘晓飞,等.瑞芬太尼复合丙泊酚用于腹腔镜胆囊切除术的麻醉效果观察[J].中国现代医生,2013,51(32):107-108.
[5]王建设,丛静.腹腔镜胆囊切除术中应用瑞芬太尼复合丙泊酚静脉麻醉的效果分析[J].国际医药卫生导报,2016,22(1):86-88.DOI:10. 3760/cma. j. issn. 1007-1245. 2016. 01. 030.
[6]王怀彬.瑞芬太尼复合丙泊酚麻醉对腹腔镜胆囊切除术中血流动力学的影响[J].河南外科学杂志,2016,22(6):115-116.
[7]王永强,杨晓.瑞芬太尼复合丙泊酚用于腹腔镜胆囊切除术的麻醉效果探讨[J].基层医学论坛,2017,21(22):2940-2941. DOI:10. 19435/j. 1672-1721. 2017. 22. 039.
[8]孙功耀.研究瑞芬太尼复合丙泊酚用于腹腔镜胆囊切除术的麻醉效果[J].实用中西医结合临床,2017,17(5):73-74. DOI:10.13638/j. issn. 1671-4040. 2017. 05. 046.
[9]徐明霞.瑞芬太尼和舒芬太尼分别复合丙泊酚静脉麻醉对腹腔镜胆囊切除术患者心血管应激的影响[J].河南外科学杂志,2017,23(5):59-61.