异丙酚防治PPH术中内脏牵拉反应的临床研究

Clinical Trial of Propofol for Preventing ＆ Treating Splanchnic Drawer Reaction during PPH

为探讨异丙酚静脉麻醉用于吻合器痔上黏膜环切术（PPH）中的可行性，将96例混合痔分为两组，Ⅰ组为异丙酚组50例，Ⅱ组为哌氟组46例。常规实施骶管麻醉，Ⅰ组病人在手术开始时静脉注射异丙酚50～90mg，Ⅱ组在手术开始时静脉注射哌替啶1mg／kg，氟哌利多2．5～5mg。分别记录病人呼吸、脉搏、平均动脉压（MAP）和氧饱和度数值，并详细记录内脏牵拉反应情况。结果显示，在PPH击发时两组的MAP、心率（HR）与术前无明显差异（P〉0．05）。Ⅰ组减轻术中牵拉直肠反应有效率（98％）明显好于Ⅱ组（67％，P〈0．05）。结果表明，异丙酚用于PPH术中可减轻内脏牵拉反应，且起效迅速，效果确切，未见严重不良反应。

The objective of this study was to probe into the feasibility of propofol anesthesia used in PPH. Authors.divided 96 patients with mixed hemorrhoids into two groups： Ⅰ and Ⅱ groups. In both groups routine sacral canal anesthesia,then at start of operation the patients（ n =50） of Ⅰ group received propofol of 50-90mg,i. v,while the patients（ n =46） of Ⅱ group received isonipecain of lmg/kg and Droperidol of 2.5-5.0mg. Then breathing,pulse,mean artery pressure（MAP） and oxygen saturation data were observed, specially status of splanchnic drawer reaction were recorded in detail. As results, at percussion of PPH in MAP and HR there was no significant difference（ P 〉0.05）, but in decreasing rectal drawer reaction group was better than Ⅱ group（98% vs 67%, P 〈0.05） ,i. v. Propotol used in PPH can reduce splanchnic drawer reaction,and has advanges such as faster onset, certain efficacy, no severe adverse reation.