不同麻醉方案用于剖宫产对产妇炎症因子和应激反应的影响

Effect of Different Anesthesia Regimens on Maternal Inflammatory Factors and Stress Response in Cesarean Section

为了探讨七氟醚与异丙酚分别联合瑞芬太尼用于剖宫产麻醉对产妇血清炎症因子及应激反应的影响。本研究选取2014年1月至2016年1月本院实施剖宫产手术的120例产妇,随机分为七氟醚组和异丙酚组,每组各60例,分别监测记录两组产妇在不同时间点的平均动脉压（MAP）、心率（HR）、血清炎症因子及应激反应指标。结果显示,在T0时刻,两组产妇的MAP监测值无明显差异（p〉0.05）;在T1、T2时刻,七氟醚组MAP监测值明显高于异丙酚组（p〈0.05）;产前1 d,两组产妇血清中的IL-6、TNF-α、IL-10水平无明显差异（p〉0.05）;在分娩后12 h、24 h,七氟醚组血清中的IL-6、TNF-α、IL-10水平明显低于异丙酚组（p〈0.05）;产前1 d,两组产妇血清中Ne、Cor、ACTH水平无明显差异（p〉0.05）;在分娩后12 h、24 h,七氟醚组血清中Ne、Cor、ACTH水平明显低于异丙酚组（p〈0.05）。七氟醚联合瑞芬太尼较异丙酚联合瑞芬太尼用于剖宫产麻醉效果更佳,能够抑制产妇的炎性反应及应激反应。

To investigate the effects of sevoflurane and propofol combined with remifentanil on cesarean section anesthesia on serum inflammatory factors and stress response. 120 maternal women who underwent cesarean section in our hospital from January 2014 to January 2016 were randomly divided into sevoflurane group and propofol group, with 60 cases in each group. The maternal women were monitored at different times Point mean arterial pressure（MAP）, heart rate（HR）, serum inflammatoryfactors and stress response indicators. The results showed that at T0, there was no significant difference in MAP monitoring between the two groups（p〉0.05）. At T1 and T2,MAP monitoring in sevoflurane group was significantly higher than that in propofol group（p〈0.05） Serum levels of IL-6, TNF-α and IL-10 in the two groups had no significant difference（p〉0.05） one day before delivery. Serum levels of sera IL-6（p〈0.05）. There was no significant difference in Ne, Cor and ACTH levels between the two groups（p〉0.05）Serum levels of Ne, Cor and ACTH in sevoflurane group were significantly lower than those in propofol group at12 and 24 hours（p〈0.05）. Sevoflurane and remifentanil than propofol combined with remifentanil for cesarean section anesthesia better, can inhibit the maternal inflammatory response and stress response.