腹腔镜手术患者异丙酚麻醉对应激因子和血流动力学的影响研究

    Impact of Propofol in Stress Factors and Hemodynamic Index during Laparoscopic Surgery

    • 摘要: 目的 探讨腹腔镜手术患者异丙酚麻醉对应激因子和血流动力学的影响。 方法 以2013年1月至2016年5月12日在本院行腹腔镜手术的100例患者为研究对象。将100例患者按照随机数字法分为观察组(异丙酚组)和对照组(异氟醚组)各50例。取麻醉前(T1)、气腹前(T2)、气腹后 15 min(T3)和解除气腹后 15 min(T4)四个时点,分析比较手术过程中两组患者的血流动力学指标: 心率、血氧饱和度、平均动脉压以及血浆中血栓素B2和6-酮-前列腺素F1α含量。 结果 观察组患者在不同时点平均动脉压和心率未见显著性差异(P>0.05);对照组平均动脉压和心率在T2时点开始出现波动(P<0.05);两组的血氧饱和度在手术过程中未见显著性差异(P>0.05)。两组患者在T1和T2时点血浆血栓素B2和6-酮-前列腺素F1α含量差异无显著性(P>0.05);对照组在T3、T4时点血浆血栓素B2显著下降(P<0.05),6-酮-前列腺素F1α含量明显升高(P<0.05);因此在手术过程中血栓素B2/6-酮-前列腺素F1α显著升高(P<0.05),而观察组血栓素B2/6-酮-前列腺素F1α未见显著性差异(P>0.05)。 结论 腹腔镜手术中采用异丙酚进行麻醉可避免血浆血栓素B2和6-酮-前列腺素F1α失调,维持机体的血流动力学平稳。

       

      Abstract: Objective To study the impact of Propofol in stress factors and hemodynamic index during laparoscopic surgery. Method 100 patients had performed the laparoscopic surgery from January 2013 to May 12, 2016 in our hospital were selected. The subjects were randomly divided into observation group (Propofol) and control group (Isoflurane), 50 cases each group. Established 4 time points as follow: before anesthesia (T1), before pneumoperitoneum (T2), after 15 min of pneumoperitoneum (T3) and after 15 min of eliminating pneumoperitoneum (T4). The index of HR (heart rate), SpO2 (surplus pulse O2) and MAP (mean arterial pressure) as well as the content of TXB2 (thromboxane B2) and 6-keto-PGF1α (6-keto-prostaglandin-F1α) were observed. Result At each time period, the index of MAP and HR for observation group was not significantly different (P>0.05); since T2, the index of MAP and HR for control group was changed (P<0.05); during surgery, the index of SpO2 for two groups was not significantly different (P>0.05); at T1 and T2, the content of TXB2 and 6-keto-PGF1α for two groups was not significantly different (P>0.05);at T3 and T4, the content of TXB2 for control group was reduced (P<0.05); the content of 6-keto-PGF1α was increased (P<0.05); during surgery, the index of TXB2/6-keto-PGF1α was increased (P<0.05); the index of TXB2/6-keto-PGF1α for observation group was not significantly different (P>0.05). Conclusion During the laparoscopic surgery, Propofol can avoid the imbalance of TXB2 and 6-keto-PGF1α and maintain the hemodynamic stability.

       

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