不同浓度麻醉药物在腹腔镜宫外孕手术中的临床效果

Clinical Effects of Different Concentrations of Narcotic Drugs in Laparoscopic Ectopic Pregnancy Operation

目的探讨在腹腔镜宫外孕手术中不同浓度麻醉药物的临床效果。方法随机选取2017年5月至2018年5月在我院就诊的90例宫外孕患者,根据年龄,孕周,妊娠部位情况等情况随机分为A组,B组和C组,三组分别有30例患者。对三组患者均使用丙泊酚、瑞芬太尼进行麻醉,三组的瑞芬太尼和丙泊酚使用浓度分别为:A组瑞芬太尼浓度为8.0 ng/mL,丙泊酚浓度为2.5μg/mL;B组瑞芬太尼浓度为6.0 ng/mL,丙泊酚浓度为23.0μg/mL;C组瑞芬太尼浓度为4.0 ng/mL,丙泊酚浓度为3.5μg/mL。观察对比记录三组患者的动脉收缩压数值,各时间点心率,苏醒时间和拔管时间。结果对患者建立气腹前后,在动脉收缩压和心率方面:A组患者的动脉收缩压比较稳定,但是心率明显加快;B组患者的动脉收缩压和心率均相对维持稳定;C组患者的动脉收缩压明显升高,且心率也明显加快。在苏醒时间和拔管时间上:A组患者的苏醒时间和拔管时间最短;B组患者的苏醒时间和拔管时间次之;C组患者的苏醒时间和拔管时间最长,P<0.05,具有统计学意义上的差异显著性。结论在腹腔镜宫外孕手术中不同浓度的麻醉药物的临床效果不同,探讨出合适浓度的麻醉药物在手术顺利中具有重要的临床意义。

Objective To investigate the clinical effect of different concentrations of narcotic drugs in laparoscopic ectopic pregnancy operation.Methods 90 cases of patients with ectopic pregnancy who were treated in our hospital from May 2017 to May 2018 were randomly divided into group A,group B and group C according to their ages,gestational weeks and location of pregnancy.There were 30 cases of patients in each group.Remifentanil and remifentanil were used for anesthesia in all three groups.The concentrations of remifentanil and propofol were 8.0 ng/mL and 2.5μg/mL in group A,6.0 ng/mL and 23.0μg/mL in group B,4.0 ng/mL and 3.5μg/mL in group C,respectively.The systolic blood pressures,heart rates,recovery time and extubation time were observed and recorded.Results Before and after the establishment of pneumoperitoneum,in terms of arterial systolic pressure and heart rate,the arterial systolic pressure in group A was relatively stable,but the heart rate was signifi cantly accelerated;the arterial systolic pressure and heart rate in group B were relatively stable;the arterial systolic pressure in group C was signifi cantly increased,and the heart rate was also signifi cantly accelerated.In terms of recovery time and extubation time,group A had the shortest recovery time and extubation time,group B had the second recovery time and extubation time,and group C had the longest recovery time and extubation time,P<0.05,with statistical signifi cance.Conclusion The clinical effects of different concentrations of anesthetics in laparoscopic ectopic pregnancy surgery are different.It is important to explore the appropriate concentration of anesthetics in the operation.