摘要
目的:对比七氟醚与丙泊酚联合瑞芬太尼麻醉在腹腔镜下子宫肌瘤切除术(LM)中的应用效果。方法:选取2022年1月—2023年12月在南阳市中心医院行LM的205例患者,根据随机数字表法分为对照组(102例,术中使用丙泊酚联合瑞芬太尼进行麻醉)和观察组(103例,术中使用七氟醚联合瑞芬太尼进行麻醉)。两组均观察至出院。比较两组各项指标。结果:与对照组比,观察组自主呼吸、睁眼时间更短(P<0.05);插管后(T_(2))至手术结束(T_(4)),观察组心率(HR)低于对照组(P<0.05),血氧饱和度(SpO_(2))高于对照组(P<0.05);气腹后(T_(3)),观察组收缩压(SBP)和舒张压(DBP)均低于对照组(P<0.05);术后1 d两组皮质醇(COR)、去甲肾上腺素(NA)、前列腺素E_(2)(PGE_(2))水平均比术前升高,但观察组均低于对照组(P<0.05);观察组住院期间不良反应总发生率低于对照组(P<0.05)。结论:对行LM患者术中采用七氟醚联合瑞芬太尼进行麻醉可促进其术后麻醉苏醒,调节其手术期间血流动力学指标,减轻应激反应,安全性较高。
Objective:To compare the effects of sevoflurane versus propofol combined with remifentanil anesthesia in laparoscopic myomectomy(LM).Methods:A total of 205 patients undergoing LM at Nanyang Central Hospital from January 2022 to December 2023 were selected and divided into a control group(102 cases,receiving propofol combined with remifentanil during surgery)and an observation group(103 cases,receiving sevoflurane combined with remifentanil during surgery)using a random number table method.Both groups were observed until discharge.Various indicators were compared between the two groups.Results:Compared with the control group,the observation group had shorter spontaneous breathing recovery time and eye-opening time(P<0.05).From post-intubation(T_(2))to the end of surgery(T_(4)),the observation group exhibited lower heart rate(HR)and higher blood oxygen saturation(SpO_(2))than the control group(P<0.05).After pneumoperitoneum(T_(3)),the systolic blood pressure(SBP)and diastolic blood pressure(DBP)in the observation group were lower than those in the control group(P<0.05).At 1 day postoperatively,cortisol(COR),norepinephrine(NA),and prostaglandin E_(2)(PGE_(2))levels increased in both groups compared with preoperative levels,but the observation group had lower levels than the control group(P<0.05).The total incidence of adverse reactions during hospitalization was lower in the observation group than in the control group(P<0.05).Conclusion:For patients undergoing LM,intraoperative anesthesia with sevoflurane combined with remifentanil can promote postoperative recovery,regulate intraoperative hemodynamic stability,reduce stress response,and improve safety.
作者
杨文哲
周威
周勇
YANG Wenzhe;ZHOU Wei;ZHOU Yong(Department of Anesthesiology,Nanyang Central Hospital,Nanyang 473000,China)
出处
《延边大学医学学报》
2025年第9期54-57,共4页
Journal of Medical Science Yanbian University
基金
2023年度南阳市科技发展计划项目(编号:23KJGG098)
