丙泊酚复合地佐辛对无痛人流患者术后血清皮质醇、肾素、血管紧张素及血流动力学指标影响

Influence of propofol combined with dezocine on cortisol,renin,angiotensin and hemodynamic indexes in patients with painless artificial abortion

目的:观察丙泊酚复合地佐辛对无痛人流患者术后应激激素、血流动力学的影响及其镇痛效果。方法:收集本院收诊进行无痛人流术的患者,随机分成对照组和观察组两组各92例。对照组患者采用丙泊酚麻醉,观察组患者则采用丙泊酚联合地佐辛。比较两组间术后应激激素水平及手术过程中血流动力学指标变化并统计两组间丙泊酚用量、麻醉效果及术后恢复情况差异。结果:术后观察组Cor、NE、ACTH高于对照组,A-Ⅰ、A-Ⅱ则低于对照组;手术过程中观察组HR、CI、SpO2高于对照组,而SVR低于对照组;苏醒时观察组HR、CI、SpO2亦高于对照组;观察组丙泊酚用量低于对照组,而麻醉效果为优的比例则高于对照组,而且术后VAS评分低于对照组,差异均具有统计学意义(P<0.05)。结论:丙泊酚联合地佐辛用于无痛人流患者的静脉麻醉,应激激素波动小,且对血流动力学影响低,能有效降低丙泊酚的用量,提高麻醉效果,同时减轻术后的宫缩疼痛感。

Objective. To investigate the influence of propofol combined with dezocineon on stress hormones, hemodynamie indexes and its analgesic effect in patients with painless artificial abortion. Meth- ods：A total of 184 patient with painless artificial abortion from January 2011 to January 2013 were ran- domly divided into control group（anesthesia by propofol） （n= 92 cases） and observation group（anesthesia by propofol combined with dezocine）（n= 92 cases）, then the indexes of stress hormones, hemodynamic in- dexes of two groups before and after the surgery were compared. And the status of analgesic, postopera- tive recovery between two groups were also been compared. Results.Serum Cot, NE, ACTH of observa-tion group after the surgery were all higher than those indexes of control group, and serum A-I , A-Ⅱ were significantly lower than those indexes of control group （all P〈0.05）. Indexes of HR, CI, SpO2 dur- ing and after the surgery were significantly higher than those in control group （all P〈0.05）. Compared with control group, the dose of propofol was lower, the analgesic effect was more significant and the scores of VAS was significantly lower in observation group （all P〈0.05）. Gonclusions： Propofol com- bined with dezocine has fewer fluctuation of stress hormones. It has little effect on hemodynamic effect and more satisfactory analgesic effect. It could effectively reduce contractions pain.