不同麻醉药物配伍对老年腹腔镜下肿瘤切除手术患者临床效果观察

Clinical observation of different narcotic drugs compatibility in elderly patients with laparoscopic tumor resection

目的探讨不同麻醉药物配伍对老年腹腔镜下肿瘤切除手术患者临床效果。方法选取该院于2015年6月至2017年6月期间收治的行老年腹腔镜下肿瘤切除术患者86例,根据随机数字表法分为观察组与对照组,各43例。对照组采用丙泊酚配合右美托咪定麻醉维持,观察组采用七氟醚配合右美托咪定麻醉维持。结果观察组麻醉总满意率(97.67%)高于对照组(79.07%),差异有统计学意义(P<0.05);两组术后3h和24h警觉-镇静(OAAS)评分较术毕增加,差异有统计学意义(P<0.05);观察组术后3h和24hOAAS评分高于对照组,差异有统计学意义(P<0.05);观察组拔管时间、呼之睁眼时间和自主呼吸恢复时间快于对照组,差异有统计学意义(P<0.05);两组T1时刻心率(HR)、平均动脉压(MAP)较T0时刻降低,差异有统计学意义(P<0.05),对照组T2时刻HR、MAP较T0时刻降低,差异有统计学意义(P<0.05),而观察组T2时刻HR、MAP较T0时刻无明显变化,差异无统计学意义(P>0.05);两组T0、T1和T2时刻HR、MAP和血氧饱和度(SpO2)比较无统计学意义(P>0.05);观察组T1和T2时刻HR、MAP高于对照组,差异有统计学意义(P<0.05)。结论七氟醚配合右美托咪定麻醉配伍对老年腹腔镜下肿瘤切除手术患者效果明显,镇静良好,对患者HR、MAP和SpO2影响小。

Objective To investigate clinical observation of different narcotic drugs compatibility in elderly patients with laparoscopic resection of tumor.Methods From June 2015 to June 2017,86 cases of elderly laparoscopic tumor resection were selected from our hospital.They were divided into the observation group and the control group according to the random number table,each with 43 cases.The control group received propofol and dexmedetomidine anesthesia,and the observation group received sevoflurane and dexmedetomidine anesthesia maintenance.Results The observation group anesthesia total satisfaction rate（97.67%）higher than that of the control group（79.07%）,the difference was statistically significant（P〈0.05）;The two group after 3 hand 24 hOAAS score increased after operation,the difference was statistically significant（P〈0.05）;The patients in the observation group 3 hand 24 hOAAS were higher than those of the control group,the difference was statistically significant（P〈0.05）;The observation group extubation time,called the open time and the recovery time of spontaneous breathing faster than the control group,the difference was statistically significant（P〈0.05）;Two group T1 time HR MAP compared with T0 time reduction,the difference was statistically significant（P〈0.05）;The control group at T2 of HR and T0 of MAP were constantly reduced,the difference was statistically significant（P〈0.05）,while the observation group at T2 HR and MAP did not change significantly compared with T0 time,the difference was not statistically significant（P〉0.05）;Two group T0,T1 and T2 HR,MAP and SpO2 time was not statistically significant（P〉0.05）;The observation group T1 and T2 HR,MAP times higher than that of the control group,the difference was statistically significant（P〈0.05）.Conclusion Sevoflurane combined with dexmedetomidine combined anesthesia in elderly patients with laparoscopic resection surgery is obviously good effect,little influence on sedation,patients with HR,MAP and SpO2.