复合丙泊酚和瑞芬太尼麻醉维持对腹部手术患者血氧指标的影响

The effect of propofol combined with remifentanil anesthesia on the oxygen saturation of blood of patients undergoing abdominal surgery

目的探讨复合异丙酚和瑞芬太尼麻醉维持对腹部手术患者血氧指标的影响。方法择期拟行腹部手术的患者80例,随机分为观察组（A组）和对照组（B组）,每组40例。A组患者麻醉诱导后采用丙泊酚复合瑞芬太尼进行麻醉维持,B组患者麻醉诱导后采用七氟醚吸入,芬太尼静脉输注维持麻醉。观察入室时（T0）、气管插管时（T1）、手术开始时（T2）、手术开始30min（T3）、拔管后（T4）的平均动脉血压（MAP）、心率（HR）、氧分压（Sp O2）、呼气末二氧化碳分压（PETCO2）并记录。分别记录手术时间、清醒时间、拔管时间以及麻醉用药量。观察并比较A、B两组患者术后恶心呕吐（PONV）发生率。结果与T0时比较,T1~T4时A组MAP明显低于B组（P〈0.05）;T3、T4时A组的MAP明显降低（P〈0.05）;与B组比较,A组T1~T4时MAP明显降低;T2~T4时HR明显减慢（P〈0.05）。T0时,两组患者Sp O2差异比较无统计学意义;与B组比较,A组T1~T4时Sp O2明显高于B组（P〈0.05）。两组患者PETCO2差异比较无统计学意义。两组患者的手术时间、清醒时间、拔管时间差异均无统计学意义（P〉0.05）。A组PONV发生率（15.0%）明显低于B组（32.5%）,差异有统计学意义（P〈0.05）。结论复合丙泊酚和瑞芬太尼应用于腹部手术患者麻醉维持可有效维持术中血流动力学及血氧指标稳定。

Objective To explore the effect of propafol combined with remifentanii anesthesia on the oxygen saturation of blood of patients undergoing abdominal surgery. Methods Eighty patients undergoing abdominal surgery were randomly divided into observation group （ group A） and control group （group B）. During maintenance of anesthesia, the observation group was treated with propofol combined with remifentanil by continuous infusion and the control group was treated with isoflurane inhalation, fentanyl intravenous injection during maintenance of anesthesia. MAP, HR, SpO2 , PETCO2 were observed at the time entering the OR （ T0） , immediately after intubation （ T1）, surgery beginning（ T2 ） , 30 min after the surgery beginning （ T3 ） and immediately after extubation （ T4 ）. The time of operation, extubation awakening and drug dosage were recorded. The incidence of PONV were observed after the operation. Results Compared with TO , MAP at T1-T4 in group D were decreased significantly （ P 〈0.05）. MAP at T3 and T4 in group D were decreased significantly （ P 〈0.05）. Compared with group C , MAP at T1-T4 in group D were decreased significantly （ P 〈 0.05 ） ; HR at T2- T4 were decreased in group D （ P 〈 0.05 ）. The incidence of PONV in group A was lower than in group B （ P 〈 0.05 ）. Conclusion The application of propofol combined with remifentanil anesthesia of patients undergoing abdominal surgery could maintain stable hemodynamics and oxygen saturation of blood.