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1、晞；紺桶关合®®竟子朗辟术中的2018-03-2001:26:12中国现代医生2018年1期陈清娟陈健陈宏才［摘要］戸的探討舒芬太尼与瑞芬太尼联合麻醉对腹腔镜子宫切除手术患者血清一氧化氮(NO)/内皮素邛(ET-1)平衡及血流动力学影响。方法将72例择期腹腔镜子宫切除手术患者随机分为联合组和对照组，分别采用舒芬太尼联合瑞芬太尼麻醉及单独瑞芬太尼麻醉。记录两组麻醉诱导前(T1)、诱导后(T2)、插管时(T3)及拔管时(T4)血清NO及ET-1水平、血流动力学变化及不良反应。结果对照组T2、T3、T4吋HR和MAP与T1时比
2、较均上升(P<0.05),联合组T2、T3、T4吋HR和MAP与T1时比较变化不明显(P>0.05),且对照组T2、T3、T4时HR和MAP高于同时点联合组(P<0.05)o两组T2、T3、T4时NO及ET-1水平与巧时比较均上升(P<0.05),联合组NO水平上升幅度小于对照组，ET-1水平上升幅度大于对照组(Pv0.05)o两组治疗中共发生药物不良反应6例，联合组4例，对照组2例，两组差异不明显(X2=0.18,P>0.05)。结论舒芬太尼与瑞芬太尼联合麻醉用于腹腔镜子宫切除术对血流动力学影响小，安全性较好，作用可能
3、与其可更好维持血清NO/ET-1平衡、改善内皮细胞功能密切和关。［关键词］腹腔镜子宫切除术；舒芬太尼；瑞芬太尼；一氧化氮；内皮素・1；血流动力学［中图分类号］R614［文献标识码］B［文章编1673-9701(2018)01-0111-04ApplicationofsufentanilcombinedwithremifentanilinlaparoscopichysterectomyCHENQingjuardCHENJianlCHENHongcai2DepartmentofAnesthesiology,TaizhouEn
4、zeMedicalCenter(Group)TaizhouHospitalAffiliatedMaternityHospitalinZhejiangProvince,Taizhou318000,China；2.DepartmentofAnesthesiology,TaizhouEnzeMedicalCenter(Group)LuqiaoHospital,Taizhou318050,China［Abstract］ObjectiveToinvestigatetheeffectofsufentanilcombinedwithr
5、emifentanilonserumnitricoxide(NO)/endotheli(ETbalaneeandhemodynamicsinpatientsundergoinglaparoscopichysterectomy.Methods72casesofelectivelaparoscopichysterectomywererandomlydividedintocombinedgrouptreatedwithsufentanilcombinedwithremifentanilanesthesiaandcontrolg
6、rouptreatedwithremifentanilalone.ThelevelsofserumNOandET-1,hemodynamicsandadversereactionsinthetwogroupswererecordedbeforeinduction(T1),afterinduction(T2),whenintubation(T3)andwhenextubation(T4)・ResultsTheHRandMAPatT2,T3andT4wereincreasedcomparedwiththoseatT1inth
7、econtrolgroup(P<0.05).AndthechangesofHRandMAPwerenotsignificantatT2,T3andT4comparedwiththoseatT1inthecombinedgroup(P>0.05)・TheHRandMAPinthecontrolgroupwerehigherthanthoseofthecombinedgroupatT2,T3andT4(P<0.05).ThelevelsofNOandET-1inthetwogroupsatT2,T3andT4wereincr
8、easedcomparedwiththoseatTKP<0.05).TheincreaserateofNOlevelinthecombinedgroupwaslowerthanthatinthecontrolgroup（P<0.05）.TheincreaserateofET-1inthecombinedgroupwa
