目的探讨丙泊酚复合瑞芬太尼靶控在腹腔镜异位妊娠手术中的应用效果。方法 60例异位妊娠患者,通过随机数字表法分为观察组和对照组,各30例。观察组丙泊酚和瑞芬太尼血浆靶浓度分别为2.5μg/ml和8 ng/ml,对照组丙泊酚和瑞芬太尼血浆靶浓...目的探讨丙泊酚复合瑞芬太尼靶控在腹腔镜异位妊娠手术中的应用效果。方法 60例异位妊娠患者,通过随机数字表法分为观察组和对照组,各30例。观察组丙泊酚和瑞芬太尼血浆靶浓度分别为2.5μg/ml和8 ng/ml,对照组丙泊酚和瑞芬太尼血浆靶浓度分别为3.5μg/ml和4 ng/ml,比较两组患者手术不同时间血流动力学[平均动脉压(MAP)、心率(HR)]及血压[收缩压(SBP)和舒张压(DBP)]情况、术后唤醒时间。结果两组患者麻醉诱导前MAP、HR、SBP、DBP比较,差异无统计学意义(P>0.05)。观察组患者气腹后15 min DBP为(79.91±7.23)mm Hg(1 mm Hg=0.133kPa)低于气腹后5 min的(84.24±6.28)mm Hg,差异具有统计学意义(P<0.05);对照组患者插管时MAP、气腹后15 min MAP、拔管时MAP、插管时HR、气腹后5 min HR、拔管时HR、拔管后5 min HR、插管时SBP、气腹时SBP、气腹后15 min SBP、拔管时SBP、插管时DBP、气腹后5 min DBP、拔管后5 min DBP与同组前一时刻比较,差异均具有统计学意义(P<0.05)。观察组术后唤醒时间(7.2±1.5)min短于对照组的(15.1±3.6)min,差异具有统计学意义(P<0.05)。结论在腹腔镜异位妊娠手术中给予丙泊酚复合瑞芬太尼靶控输注效果显著,推广价值高。展开更多
Objective To evaluate the feasibility and safety of operative laparoscopy for ectopic pregnancy with hypovolemic shock. Methods Two hundred and fifteen women with ectopic pregnancy underwent operative laparoscopy. The...Objective To evaluate the feasibility and safety of operative laparoscopy for ectopic pregnancy with hypovolemic shock. Methods Two hundred and fifteen women with ectopic pregnancy underwent operative laparoscopy. These patients were divided into two groups. The study group included 21 patients with shock and intraperitoneal hemorrhage more than 1000 mL, and control group included 194 patients, hemodynamically stable, with blood loss less than 1000 mL. Clinical data of perio-perative periods in two groups were retrospectively analyzed. Results All patients were tubal pregnancies. The occurrence rate of tubal rupture was higher in study group than in control group (80.95% vs. 15.98%, P < 0.001). Intraabdominal blood loss was significantly higher in study group than in control group (1900 mL vs. 300 mL, P < 0.001), and autologous blood transfusions were given to 95.24% and 9.3% of patients in study and control group, respectively (P < 0.001). Laparoscopic salpingectomy was performed on 85.7 % and 50.5% of patients in study and control group (P < 0.001). The operative time was somewhat longer in study group than that in control group (60 minutes vs. 45 minutes), but with no significant difference. All patients had no perioperative complications. Conclusion Operative laparoscopy in patients with hopovolemic shock can be safely and effectively performed by experi-enced laparoscopists with the aid of optimal anesthesia, advanced cardiovascular monitoring, and autologous blood transfusion.展开更多
文摘目的探讨丙泊酚复合瑞芬太尼靶控在腹腔镜异位妊娠手术中的应用效果。方法 60例异位妊娠患者,通过随机数字表法分为观察组和对照组,各30例。观察组丙泊酚和瑞芬太尼血浆靶浓度分别为2.5μg/ml和8 ng/ml,对照组丙泊酚和瑞芬太尼血浆靶浓度分别为3.5μg/ml和4 ng/ml,比较两组患者手术不同时间血流动力学[平均动脉压(MAP)、心率(HR)]及血压[收缩压(SBP)和舒张压(DBP)]情况、术后唤醒时间。结果两组患者麻醉诱导前MAP、HR、SBP、DBP比较,差异无统计学意义(P>0.05)。观察组患者气腹后15 min DBP为(79.91±7.23)mm Hg(1 mm Hg=0.133kPa)低于气腹后5 min的(84.24±6.28)mm Hg,差异具有统计学意义(P<0.05);对照组患者插管时MAP、气腹后15 min MAP、拔管时MAP、插管时HR、气腹后5 min HR、拔管时HR、拔管后5 min HR、插管时SBP、气腹时SBP、气腹后15 min SBP、拔管时SBP、插管时DBP、气腹后5 min DBP、拔管后5 min DBP与同组前一时刻比较,差异均具有统计学意义(P<0.05)。观察组术后唤醒时间(7.2±1.5)min短于对照组的(15.1±3.6)min,差异具有统计学意义(P<0.05)。结论在腹腔镜异位妊娠手术中给予丙泊酚复合瑞芬太尼靶控输注效果显著,推广价值高。
文摘Objective To evaluate the feasibility and safety of operative laparoscopy for ectopic pregnancy with hypovolemic shock. Methods Two hundred and fifteen women with ectopic pregnancy underwent operative laparoscopy. These patients were divided into two groups. The study group included 21 patients with shock and intraperitoneal hemorrhage more than 1000 mL, and control group included 194 patients, hemodynamically stable, with blood loss less than 1000 mL. Clinical data of perio-perative periods in two groups were retrospectively analyzed. Results All patients were tubal pregnancies. The occurrence rate of tubal rupture was higher in study group than in control group (80.95% vs. 15.98%, P < 0.001). Intraabdominal blood loss was significantly higher in study group than in control group (1900 mL vs. 300 mL, P < 0.001), and autologous blood transfusions were given to 95.24% and 9.3% of patients in study and control group, respectively (P < 0.001). Laparoscopic salpingectomy was performed on 85.7 % and 50.5% of patients in study and control group (P < 0.001). The operative time was somewhat longer in study group than that in control group (60 minutes vs. 45 minutes), but with no significant difference. All patients had no perioperative complications. Conclusion Operative laparoscopy in patients with hopovolemic shock can be safely and effectively performed by experi-enced laparoscopists with the aid of optimal anesthesia, advanced cardiovascular monitoring, and autologous blood transfusion.
