丙泊酚复合地佐辛对行异位妊娠腹腔镜手术患者的血流动学指标、应激激素及镇痛效果影响的研究

Effect of propofol combined with dizosin on hemodynamic parameters,stress hormones and analgesic effect in patients undergoing laparoscopic surgery for ectopic pregnancy

目的探讨丙泊酚复合地佐辛对行异位妊娠腹腔镜手术患者的血流动学指标、应激激素及镇痛效果的影响。方法选取110例异位妊娠患者,根据随机数字表法分为研究组与对照组,每组55例。对照组推注丙泊酚,研究组则推注丙泊酚复合地佐辛。比较两组患者的血流动力学指标、应激激素及镇痛效果。结果麻醉前,两组患者平均动脉压(MAP)、心率(HR)、脉搏指数(SI)及脉搏血氧饱和度(SpO_(2))指标比较,差异无统计学意义(P>0.05);手术后,对照组的HR、SI及SpO_(2)指标与麻醉前比较,差异具有统计学意义(P<0.05),研究组的MAP、HR、SI及SpO_(2)指标与麻醉前比较,差异无统计学意义(P>0.05)。麻醉前,两组患者的皮质醇(Cor)、肾素(Rn)、血管紧张素Ⅰ(A-Ⅰ)、血管紧张素Ⅱ(A-Ⅱ)、去甲肾上腺素(NE)及促肾上腺皮质激素(ACTH)水平比较,差异无统计学意义(P>0.05);手术后,两组血清Cor及A-Ⅰ、A-Ⅱ、NE及ACTH水平与麻醉前比较,差异具有统计学意义(P<0.05),且研究组的变化趋势小于对照组(P<0.05)。对照组的Rn水平和麻醉前比较显著增加(P<0.05),但与研究组比较,差异无统计学意义(P>0.05)。研究组轻度疼痛患者占比21.82%高于对照组的5.45%,重度疼痛患者占比16.36%明显低于对照组38.18%,差异具有统计学意义(P<0.05)。结论对异位妊娠腹腔镜手术患者,采用丙泊酚复合地佐辛联合麻醉诱导,剂量合适,安全性高,值得临床推广。

Objective To investigate the effects of propofol combined with desoxacin on blood flow indicators,stress hormones and analgesic effects of ectopic pregnancy laparoscopic surgery.Methods 110 patients with ectopic pregnancy were selected and divided into study group and control group according to random number table method,with 55 cases in each group.The control group was given propofol,and the study group was given propofol combined with desoxine.The hemodynamic indexes,stress hormones and analgesic effects of the two groups were compared.Results Before anesthesia,there were no significant differences in mean arterial pressure(MAP),heart rate(HR),pulse index(SI)and pulse oxygen saturation(SpO_(2))between 2 groups(P>0.05).After surgery,HR,SI and SpO_(2) indexes of the control group showed statistically significant differences compared with those before anesthesia(P<0.05),while MAP,HR,SI and SpO_(2) indexes of the research group showed no statistically significant differences compared with those before anesthesia(P>0.05).Before anesthesia,there were no significant differences in the levels of cortisol(Cor),renin(Rn),angiotensinⅠ(A-Ⅰ),angiotensinⅡ(A-Ⅱ),norepinephrine(NE)and adrenocorticotropic hormone(ACTH)between 2 groups(P>0.05).After operation,the levels of serum Cor,A-Ⅰ,A-Ⅱ,NE and ACTH in the two groups were significantly different from those before anesthesia(P<0.05),and the trend of change in the study group was less than that in the control group(P<0.05).The Rn level in the control group was significantly increased compared with that before anesthesia(P<0.05),but there was no statistical significance compared with the study group(P>0.05).The proportion of patients with mild pain in the research group was 21.82%higher than that in the control group(5.45%),and the proportion of patients with severe pain was 16.36%lower than that in the control group(38.18%),the difference was statistically significant(P<0.05).Conclusion For patients undergoing laparoscopic surgery for ectopic pregnancy,propofol combined with dizosin combined with anesthesia induction is suitable in dose and safe,which is worthy of clinical promotion.