七氟醚复合全麻在老年经皮肾镜取石术中对血流动力学的影响

Effects of Inhalation Anesthetic Sevoflurane on Hemodynamics in Old Patients During Percutaneous Nephrolithotripsy

目的探讨七氟醚复合全麻和腰硬联合麻醉(CSEA)对老年经皮肾镜取石术(PCNL)中血流动力学的改变。方法择期行PCNL老年患者60例,随机分为2组(七氟醚复合全麻组和CSEA组),记录手术前后各时点(麻醉前、体位变动时、肾脏灌注时以及手术完毕时)的舒张压(SBP)、收缩压(DBP)、平均动脉压(MAP)以及心率(HR)值。结果CSEA组体位变动时以及肾脏灌注时的血压明显低于麻醉前(P<0.01,P<0.05),七氟醚复合全麻组变化则不明显;两组体位变动和肾脏灌注时SBP差异明显(P<0.05),两组病人HR较麻醉前均有明显降低(P<0.05)。结论七氟醚复合全麻能更好地保证老年人PCNL手术的平稳。

Objective To approach the effect of inhalation anesthetic sevoflurane on hemodynamics during percutaneous nephrolithotripsy（PCNL）.Methods Sixty patients were randomized into two groups（inhalation anesthetic sevoflurane group and combined spinal epidural anesthesia group）.The diastolic blood pressure（SBP）,systolic blood pressure（DBP）,mean arterial blood pressure（MAP）,and heart rate（HR） of patients of every time point（before anesthesia,body posture alternation,kidney dabbling,end of surgery） were recorded preoperatively.Results The blood pressure of body posture alternation and kidney dabbling of CSEA group were lower than that before anesthesia（P〈0.01,P〈0.05）,there was no obvious change in the inhalation anesthetic sevoflurane group;HR of patients of the two groups were lower than that before anesthesia（P〈0.05）,but there were no significant difference between two groups.Conclusion It is safer to use sevoflurane anesthesia during percutaneous nephrolithotripsy to old patients.