丙泊酚联合瑞芬太尼用于腹腔镜胆囊切除术的临床效果观察

Clinical effect of propofol combined with remifentanil in laparoscopic cholecystectomy

目的观察丙泊酚联合瑞芬太尼靶向控制静脉滴注在腹腔镜胆囊切除术中的应用。方法选取2015年3月-2016年3月收治并确诊胆囊疾病患者120例,随机分为对照组和研究组各60例,麻醉诱导与前期处理2组患者一致,对照组在麻醉诱导完成后给予七氟醚,浓度为1%实施静脉复合吸入麻醉;研究组在麻醉诱导完成后给予瑞芬太尼、丙泊酚复合维持麻醉剂实施靶向控制静脉滴注,瑞芬太尼剂量为4μg/ml,丙泊酚剂量为2μg/ml。2对照组患者通过麻醉全程生命体征变化、术后恢复效果、术后不良反应进行比较。结果研究组与对照组通过各时段观察点的心率(HR)、血氧饱和度(SpO_2)、平均脉动压(MAP)进行比较,差异无统计学意义(P>0.05)。对照组患者T1-T3时HR与MAP明显高于T0时基础指标,差异有统计学意义(P<0.05;)对照组各时段SpO_2比较,差异无统计学意义(P>0.05)。研究组与对照组患者T0时HR、MAP与T0-T3时SpO_2比较,差异均无统计学意义P>0.05)。T1-T3研究组与对照组HR、MAP,呼吸恢复、苏醒时间、拔管时间、不良反应率均低于对照组,各项比较差异均有统计学意义(P<0.05)。结论丙泊酚联合瑞芬太尼靶向控制静脉滴注在腹腔镜胆囊切除术中可稳定机体生命体征,且利于患者麻醉苏醒,麻药不良反应率较低。

Objective propofol combined with remifentanil target controlled infusion in laparoscopic cholecystectomy.Methods the patients in March 2015- 2016 and March were diagnosed gallbladder disease,randomly selected 120 cases of patients,divided into control group and study group,anesthesia induction and early treatment in two group patients,the control group were treated with sevoflurane in anesthesia induction after the completion of the implementation of the concentration of 1% Combined Intravenous Inhalation anesthesia; the study group was given remifentanil propofol anesthetic maintenance targeted control of intravenous infusion in after anesthesia induction with remifentanil propofol dose was 4 g / ml,the dose of 2g / ml. Patients in study group and control group by anesthesia throughout the change of vital signs,recovery,postoperative adverse reactions were compared. Results the study group and the control group observed heart rate in each period by（ HR）and oxygen saturation（ SpO2）,average pulse pressure（ MAP） were compared,the difference was not statistically significant（ P〉0. 05）. Basic index of group of patients with T1- T3 HR and MAP T0 was significantly higher than that of the control,the difference was statistically significant（ P〈0. 05; SpO2） compared with the control group in each period,there was no statistically significant difference（ P〉0. 05）. Patients in study group and control group T0,HR MAP and T0- T3 SpO2,there were no significant differences in P〉0. 05）. T1- T3 study group and control group HR,MAP,respiratory recovery,recovery time,extubation time,the adverse reaction rate was lower than the control group,the differences were statistically significant（ P〈0. 05）. Conclusion propofol combined with remifentanil target controlled infusion in laparoscopic cholecystectomy can stabilize the vital signs in the operation,and conducive to recovery anesthesia in patients with adverse reaction rate is low,anesthetic.