| 赵冰晓,李 达,何 龙,金 峰,艾艳秋.七氟醚复合瑞芬太尼静吸麻醉对急性胆囊炎腹腔镜手术患者麻醉效果、血流动力学及炎性因子的影响[J].,2022,(3):515-518 |
| 七氟醚复合瑞芬太尼静吸麻醉对急性胆囊炎腹腔镜手术患者麻醉效果、血流动力学及炎性因子的影响 |
| Effects of Sevoflurane Combined with Remifentanil on Anesthesia Effects, Hemodynamics and Inflammatory Factors in Patients with Acute Cholecystitis Undergoing |
| 投稿时间：2021-06-02 修订日期：2021-06-26 |
| DOI：10.13241/j.cnki.pmb.2022.03.024 |
| 中文关键词: 七氟醚 瑞芬太尼 静吸麻醉 急性胆囊炎 腹腔镜手术 麻醉效果 血流动力学 炎性因子 |
| 英文关键词: Sevoflurane Remifentanil Intravenous anesthesia Acute cholecystitis Laparoscopic surgery Anesthetic effect Hemodynamics Inflammatory factors |
| 基金项目:河南省科技厅技术攻关项目（2017-YJ-058） |
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| 中文摘要: |
| 摘要 目的：探讨七氟醚复合瑞芬太尼静吸麻醉对急性胆囊炎腹腔镜手术患者麻醉效果、血流动力学及炎性因子的影响。方法：选取2018年1月到2019年12月期间我院收治的120例急性胆囊炎腹腔镜手术患者，根据信封抽签法分为对照组60例（丙泊酚复合瑞芬太尼）和观察组60例（七氟醚复合瑞芬太尼），对比两组麻醉效果、血流动力学、炎性因子及不良反应。结果：观察组术毕（T5）时间点心率（HR）、平均动脉压（MAP）与麻醉前（T1）比较未见显著性差异（P>0.05），观察组插管后1 min（T2）~T5时间点HR、MAP高于对照组（P<0.05）。两组术后1 d、术后3 d 肿瘤坏死因子-α（TNF-α）、C反应蛋白水平（CRP）、白介素-6（IL-6）均高于术前，观察组术后1 d、术后3 d CRP、IL-6、TNF-α低于对照组（P<0.05）。观察组自主呼吸恢复时间、定向力恢复时间、睁眼时间、言语应答时间均短于对照组（P<0.05）。两组不良反应发生率组间比较无显著性差异（P>0.05）。结论：急性胆囊炎腹腔镜手术患者采用七氟醚复合瑞芬太尼静吸麻醉，麻醉效果较好，可平稳患者血流动力学，减轻炎症应激且安全性较好。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of sevoflurane combined with remifentani on anesthesia effects, hemodynamics and inflammatory factors in patients with acute cholecystitis undergoing laparoscopic cholecystectomy. Methods: 120 patients with acute cholecystitis undergoing laparoscopic cholecystectomy in our hospital from January 2018 to December 2019 were selected, and randomly divided into control group of 60 cases(propofol combined with remifentanil) and observation group of 60 cases(sevoflurane combined with remifentanil) according to the envelope lottery. The anesthesia effect, hemodynamics, inflammatory factors and adverse reactions of the two groups were compared. Results: There was no significant difference in heart rate (HR) and mean arterial pressure (MAP) between end of operation (T5) and before anesthesia (T1) in the observation group (P>0.05), HR and MAP of the observation group at 1 min after intubation (T2)-T5 were higher than those of the control group(P<0.05). The levels of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and interleukin-6 (IL-6) of both groups from 1 d after operation to 3 d after operation in the two groups were higher than those before operation, and CRP, IL-6 and TNF-α of the observation group at 1 d after operation and 3 d after operation were lower than those of the control group(P<0.05). The speech response time, eye opening time, directional force recovery time and spontaneous breathing recovery time of the observation group were shorter than those of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Sevoflurane combined with remifentanil for acute cholecystitis patients undergoing laparoscopic surgery has good anesthetic effect, can stabilize the hemodynamics of patients, reduce inflammatory stress and it has good safety. |
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