| 赵华堂,张西增,刘爱杰,丁保峰,井玉生.丙泊酚与七氟醚用于后腹腔镜手术患者对血浆TXB2, ET-1, D-D水平的影响比较[J].,2017,17(24):4727-4730 |
| 丙泊酚与七氟醚用于后腹腔镜手术患者对血浆TXB2, ET-1, D-D水平的影响比较 |
| Comparison of the Effects of Propofol and Sevoflurane on the Plasma TXB2, ET-1 and D-D Levels of Patients Underwent Posterior Retroperitoneal Laparoscopic Surgery |
| 投稿时间：2017-02-13 修订日期：2017-02-28 |
| DOI：10.13241/j.cnki.pmb.2017.24.031 |
| 中文关键词: 七氟醚 后腹腔镜手术 血栓烷素B2 内皮素-1 D-二聚体 |
| 英文关键词: Sevoflurane Posterior laparoscopic surgery Thromboxane B2 Endothelin-1 D-dimer |
| 基金项目:山东省自然科学基金项目(2002C10) |
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| 中文摘要: |
| 摘要 目的：比较丙泊酚与七氟醚用于后腹腔镜手术患者对血浆血栓烷素B2(TXB2)、内皮素-1(ET-1)、D-二聚体(D-D)水平的影响。方法：研究对象选自我院2015年5月~2016年12月收治的行后腹腔镜手术治疗的84例患者，采取随机数字表将其分成两组，每组42例。两组患者麻醉诱导相同，观察组麻醉维持采取2%~3%七氟醚持续吸入，对照组给予丙泊酚4~12 mg/(kg?h)持续泵注，两组同时给予瑞芬太尼10 μg/(kg?h)靶控输注。分别于麻醉诱导后(T0)、气腹后0.5 h(T1)、1 h(T2)、1.5 h(T3)时点检测两组患者的血浆TXB2、ET-1、D-D含量，同时比较两组麻醉效果以及不良反应的发生情况。结果：观察组意识消失时间、气管插管时间、自主呼吸恢复时间、睁眼时间、言语应答时间、定向力恢复时间、拔管时间均显著短于对照组(P<0.01)。两组不良反应发生情况对比差异无统计学意义(P>0.05)。两组患者T1、T2、T3时点的血浆TXB2、ET-1、D-D含量均逐渐升高，且均明显高于T0(P<0.01)；观察组患者T1、T2、T3时点的血浆TXB2、ET-1、D-D含量均显著低于对照组同时点(P<0.01)。结论：后腹腔镜手术可引起不同程度的血液高凝状态。与丙泊酚相比，七氟醚用于后腹腔镜手术麻醉中可有效抑制TXB2、ET-1、D-D的释放，能起到更好抗凝作用。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the effects of propofol and sevoflurane on the plasma thromboxane B2 (TXB2), endothelin-1 (ET-1) and D-dimer (D-D) levels of patients underwent posterior retroperitoneal laparoscopic surgery. Methods: 84 cases of patients underwent post retroperitoneal laparoscopic surgery in our hospital from May 2015 to December 2016 were selected as research objectives and randomly divided into two groups with 42 cases in each group. The same anesthesia induction were provided for two groups, the observation group was given 2%~3% sevoflurane for continuous inhalation, while the control group was given 4~12 mg/(kg?h) of propofol for continuous injection by pump. Both groups received remifentanil 10 μg/(kg?h) target-controlled infusion simultaneously. The levels of plasma TXB2, ET-1 and D-D in the two groups were measured after anesthesia induction (T0), at 0.5 h(T1), 1 h (T2), 1.5 h (T3) after pneumoperitoneum. Meanwhile, the anesthetic effects and adverse reactions were compared between two groups. Results: The time of consciousness disappearence, time of tracheal intubation, spontaneous breathing recovery time, eye opening time, verbal response time, orientation recovery time and extubation time of observation group were significantly shorter than those of the control group (P<0.01). No significant difference was found in the occurrence of adverse reactions between two groups(P>0.05). The plasma TXB2, ET-1 and D-D levels of both groups were gradually increased at T1, T2 and T3, and all were significantly higher than that at T0 (P<0.01). The plsma TXB2, ET-1 and D-D levels at T1, T2 and T3 of observation group were significantly lower than those of the control group at same time (P<0.01). Conclusion: Posterior laparoscopic surgery could cause different degrees of hypercoagulability of blood. Compared with propofol, sevoflurane could effectively inhibit the release of TXB2, ET-1 and D-D in anesthesia after retroperitoneal laparoscopic anesthesia, and play a better role of anticoagulation. |
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