七氟醚全凭吸入麻醉对妇科腹腔镜手术中血流动力学的影响研究

Effects of sevoflurane inhalation anesthesia on hemodynamic study in gynecological laparoscopic surgery

目的探讨妇科腹腔镜手术中七氟醚全凭吸入麻醉对血流动力学的影响。方法选取我院妇产科2012年5月~2014年5月行腹腔镜手术的患者87例,随机分为对照组和观察组,观察组采用七氟醚全凭吸入麻醉行腹腔镜手术（n=44）,对照组采用腰硬联合麻醉行腹腔镜手术（n=43）,比较两组患者的手术期间的血流动力学变化。结果观察组患者的RR、Sp O2、PETCO2均高于对照组,差异有统计学意义（P〈0.05）。T0、T1时间点的收缩压（SBP）和舒张压（DBP）以及心率的变化不太大,而麻醉诱导后的T2、T3时点,对照组的SBP,DBP,HR低于观察组,差异有统计学意义（P〈0.05）。麻醉诱导患者前的T0、T1时间点,两组患者的NE、E、CORT、ATⅡ血液中的激素水平的差异无统计学意义（P〉0.05）;而麻醉诱导后T2、T3时间点,与T0时间点比较,差异有统计学意义（P〈0.05）,且观察组激素水平均低于对照组水平,差异有统计学意义（P〈0.05）。结论妇科腹腔镜手术中七氟醚全凭吸入麻醉时,患者血流动力学变化较稳定,是安全可靠的麻醉方式。

Objective To study the gynecologic laparoscopic surgery sevoflurane inhalation anesthesia on hemodynamics. Methods All 87 cases of patients in our hospital from May 2012 to May 2014 in Department of Obstetrics and Gynecology with laparoscopic surgery, were randomly divided into the observation group and the control group, the observation group treated with sevoflurane inhalation anesthesia for laparoscopic surgery （n=44）, the control group using combined spinal and epidural anesthesia for laparoscopic surgery（n=43）, hemodynamic changes during operation in two groups of patients were compared. Results The RR, SpO2, PETCO2 in the observation group were higher than those in the control group, the difference was statistically significant（P〈0.05）. T1 T0, the time of systolic blood pressure （SBP） and diastolic blood pressure （DBP） and heart rate did not change much after induction of anesthesia, and T2, T3 time point, the SBP, DBP, HR of control group were lower than those in the observation group, there was statistically significant difference between the two groups（P〈0.05）. Anesthesia was induced with To, T1 time points, there was no significant difference in hormone levels in two groups of patients with NE, E, CORT, ATII in the blood（P〉0.05） ; and T2 after induction of anesthesia, T3 time point, compared with the time point of To, the difference was statistically signif icant（P〈0.05）. The observation group and the hormone levels were lower than the control group, the difference was statistically significant（P〈0.05）. Conclusion Laparoscopic surgery sevoflurane inhalation anesthesia, hemodynamics of patients with stable, safe and reliable means of anesthesia.