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目的：探究丙泊酚与异氟醚麻醉对接受妇科腹腔镜手术的患者应激激素以及血流动力学的影响。方法：选取我院妇科收治的需要进行腹腔镜手术的患者90 例，根据麻醉用药不同，将其分为丙泊酚组、异氟醚组及实验组，每组各30 例。观测患者不同时段去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(COS)的浓度及心率、平均动脉压、呼吸频率、血氧饱和度等血流动力学参数的变化情况。结果：三组患者麻醉前及气腹20 min 的去甲肾上腺素、肾上腺素以及皮质醇含量比较均无显著差异(P＞0.05)；气腹前，实验组患者去甲肾上腺素含量显著低于丙泊酚组及异氟醚组(P＜0.05)；放气10 min，实验组患者肾上腺水平显著高于丙泊酚组及异氟醚组(P＜0.05)；三组患者麻醉前及气腹前的心率、平均动脉压、呼吸以及血氧饱和度比较均无显著差异(P＞0.05)；气腹20 min，实验组患者的心率、平均动脉压、呼吸显著优于丙泊酚组及异氟醚组(P＜0.05)；术后放气10 min，实验组患者的心率、平均动脉压、呼吸显著优于丙泊酚组及异氟醚组(P＜0.05)；实验组患者术后出现恶心、呕吐等症状显著优于丙泊酚组及异氟醚组(P＜0.05)。结论：丙泊酚复合异氟醚可有效改善接受妇科腹腔镜手术的患者麻醉期间的应激反应和血流动力学，患者术后恶心、呕吐等不良反应少，值得推广使用。

英文摘要:

Objective:To investigate the effect of propofol and isoflurane on the stress hormones and hemodynamics of patients undergoing gynecological laparoscopic surgery.Methods:90 patients undergoing gynecological laparoscopic operation in our hospital were selected and divided into propofol group, isoflurane group and experimental group according to different anesthesia, 30 cases in each group. The changes of norepinephrine (NE), epinephrine (E), cortisol (COS) concentration and heart rate, mean arterial pressure, respiratory rate, oxygen saturation as well as other hemodynamic parameters were observed at different time points.Results:Three groups of patients before anesthesia and pneumoperitoneum 20 min norepinephrine, epinephrine, and cortisol levels compare had no significant difference (P > 0.05); Norepinephrine levels before pneumoperitoneum, the experimental group patients was significantly lower than propofol and isoflurane group (P < 0.05); Deflated 10 min, adrenal experimental group patients were significantly higher than that of propofol and isoflurane group (P < 0.05); Three groups of patients before anesthesia and pneumoperitoneum in front of the heart rate, mean arterial pressure, respiration and blood oxygen saturation is had no significant difference (P > 0.05); Pneumoperitoneum 20 min, the experimental group the patient's heart rate, mean arterial pressure, and breathing was significantly better than that of propofol and isoflurane group (P < 0.05); Postoperative deflated 10 min, the experimental group the patient's heart rate, mean arterial pressure, and breathing significantly better than that of propofol and isoflurane group (P < 0.05); Experimental group patients postoperative symptoms such as nausea, vomiting, significantly better than that of propofol and isoflurane group (P < 0.05).Conclusion:Propofol combined with isoflurane could effectively improve the stress response and hemodynamics of patients undergoing gynecological laparoscopic surgery and had few postoperative nausea, vomiting and other adverse reactions, which was worthy of clinical application.

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