| 王 玥,白云波,曹文超,景宇淼,康 凯.七氟烷复合依托咪酯对妇科宫腔镜手术患者麻醉效果和血流动力学的影响[J].,2021,(13):2460-2463 |
| 七氟烷复合依托咪酯对妇科宫腔镜手术患者麻醉效果和血流动力学的影响 |
| Effect of Sevoflurane Combined with Etomidate on Anesthesia Effect and Hemodynamics in Patients Undergoing Gynecological Hysteroscopy Surgery |
| 投稿时间：2021-01-23 修订日期：2021-02-18 |
| DOI：10.13241/j.cnki.pmb.2021.13.012 |
| 中文关键词: 七氟烷 依托咪酯 宫腔镜手术 麻醉效果 血流动力学 |
| 英文关键词: Sevoflurane Etomidate Hysteroscopic surgery Anesthesia effect Hemodynamic |
| 基金项目:北京市卫生和计划生育委员会科技成果和适宜技术推广项目（2018-TG-21） |
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| 中文摘要: |
| 摘要 目的：研究七氟烷复合依托咪酯对宫腔镜手术患者麻醉效果和血流动力学的影响。方法：将2017年3月至2017年10月我院妇科收治的80例宫腔镜手术患者纳入研究，随机分为对照组和观察组，对照组给予七氟烷麻醉后行宫腔镜治疗，观察组则施以七氟烷复合依托咪酯进行宫腔镜治疗，采用Ramsay 镇静评分法对患者的镇静程度进行评价，采用警觉/镇静评分(OAA/S)对患者的清醒程度进行评价，监测记录患者的手术麻醉时间、手术结束后的清醒时间和术后不良反应发生情况，对患者的心率(HR)、心排出量(CO)、动脉压(MAP)、血氧饱和度（SpO2）、二氧化碳分压（PaCO2）等血流动力学指标进行监测记录，通过视觉模拟评分法（VAS）评估患者疼痛程度。结果：与对照组相比，观察组的麻醉起效时间、手术结束后的清醒时间较短(P<0.05)，而Ramsay镇静评分以及OAA/S评分较高(P<0.05)。两组患者的CO、HR、MAP、PaCO2、SpO2等血流动力学指标于T2、T3时点均显著低于T1(P<0.05)，在T4时点又有所回升，观察组CO、HR、MAP、PaCO2、SpO2等血流动力学指标在T2、T3时点高于对照组(P<0.05)，苏醒后的各时间段，观察组的VAS评分与对照组相比均较低(P<0.05)；观察组的不良反应总发生率低于对照组(P<0.05)。结论：七氟烷复合依托咪酯对宫腔镜手术患者具有较好的麻醉效果，并且对于其血流动力学稳定具有较佳的维持效果。 |
| 英文摘要: |
| ABSTRACT Objective: To study the effect of sevoflurane combined with etomidate on anesthesia effect and hemodynamics in patients undergoing gynecological hysteroscopy surgery. Methods: From March 2017 to October 2017, 80 cases of hysteroscopic surgery in our hospital were included in the study. They were randomly divided into the control group and the observation group. The control group was treated with hysteroscopy after sevoflurane anesthesia, and the observation group was treated with hysteroscopy after sevoflurane combined with etomidate, Ramsay Sedation score was used to evaluate the degree of sedation, and Alertness / sedation score (OAA/S) was used to evaluate the patients' consciousness. The anesthesia time, awake time and postoperative adverse reactions were monitored and recorded. Heart rate (HR), cardiac output (CO), arterial pressure (MAP), oxygen saturation (SpO2), partial pressure of carbon dioxide (PaCO2) and other hemodynamic indexes of patients were monitored and recorded, and the pain degree of patients was evaluated by visual analog scale (VAS). Results: Compared with the control group, the anesthesia onset time and awake time after surgery of the observation group were shorter (P<0.05), while the Ramsay Sedation score and OAA/S score were higher (P<0.05). The hemodynamic indexes such as CO, HR, MAP, PaCO2 and SpO2 in the two groups at T2 and T3 were significantly lower than those at T1(P<0.05), and their rosed again at T4. The hemodynamic indexes such as CO, HR, MAP, PaCO2 and SpO2 of the observation group at T2 and T3 were higher than those of the control group(P<0.05). The VAS score of the observation group was lower than that of the control group at each time after awakening(P<0.05). The incidence rate of adverse reactions of the observation group was lower than that of the control group (P<0.05). Conclusion: Sevoflurane combined with etomidate has a better anesthetic effect on hysteroscopic surgery patients, and has a better maintenance effect on hemodynamic stability. |
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