丙泊酚对腹腔镜下子宫肌瘤剔除术患者的麻醉效果及对缩血管因子水平的影响

Effects of Propofol on Anesthesia and Vasoconstrictor of Patients undergoing Laparoscopic Hysteromyomectomy

[目的]探讨丙泊酚对腹腔镜下子宫肌瘤剔除术患者的麻醉效果及对缩血管因子水平的影响.[方法]选择在本院行子宫肌瘤剔除术患者86例,随机分成对照组(采用舒芬太尼麻醉)和观察组(采用舒芬太尼+丙泊酚麻醉),每组各43例.比较两组患者麻醉效果.[结果]观察组患者自主呼吸恢复时间、苏醒时间短于对照组,Ramsay镇静评分高于对照组,且两组比较差异均有显著性( P <0 .05).术前30 min (T0 )两组患者血压、心率(HR)、内皮素‐1(ET‐1)、血管紧张素‐Ⅱ(AngⅡ)水平比较差异均无显著性( P >0 .05).手术30 min(T1 )、术后30 min (T2 )时,观察组患者血压较对照组平稳( P <0 .05),ET‐1 、AngⅡ水平低于对照组( P <0 .05),HR水平与对照组比较差异无显著性( P >0 .05 ).观察组患者不良反应发生率为4 .65%(2/43),明显低于对照组的18 .71%(8/43),且差异有显著性( P <0 .05).[结论]在腹腔镜下子宫肌瘤剔除术中采用舒芬太尼+丙泊酚麻醉效果好,患者生命体征平稳,对ET‐1 、AngⅡ水平影响较小,且安全性高.

[Objective]To analyze the anesthetic effect and post-surgery recovery time of propofol in patients undergoing laparoscopic hysteromyomectomy. [Methods] A total of 86 cases of uterine myomectomy were randomly divided into the control group (sufentanil alone) and the observation group (sufentanil plus propofol), with 43 in each group. The anesthetic effect of the two groups was analyzed.[Results]The recovery time and recovery time of spontaneous respiration in the observation group were shorter than those in the control group ( P<0.05). Ramsay sedation score was higher in the observation group than the control group. The difference was statistically significant ( P<0.05). At 30 min (T0) before operation, there were no significant differences in blood pressure, heart rate (HR) HR, endothelin-1 (ET-1), and angiotensin-Ⅱ(AngⅡ) levels between the two groups ( P >0.05). At 30 min (T1)during surgery and 30 min (T2) after surgery, the blood pressure of the observation group was stable compared to the control group ( P<0.05), the levels of ET-1 and AngⅡ were lower than the control group (P<0.05), and the HR level was not statistically significant difference with the control group (P>0.05). The incidence of adverse reaction rate was 4.65 (2/43) in the observation group, which was significantly lower than 18.71 in the control group ( P <0.05).[Conclusion] In the laparoscopic hysteromyomectomy, sufentanil plus propofol has good anesthetic effect with stable vital signs, little influence on ET-1 Ang Ⅱ level and high safety.