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时间:2020-04-02
《七氟醚和异氟醚麻醉在腹腔镜手术中对应激反应的影响.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、第26卷第1期川北医学院学报Vo1.26.NO.120l1年2月JOURNALOFNORTHSICHUANMEDICALCOLLEGEFeb.20Il38七氟醚和异氟醚麻醉在腹腔镜手术中对应激反应的影响杨昶,何林,左友波,杨平,胡有智,胡建会(1.攀枝花市中心医院,四川攀枝花617067;2.川北医学院附属医院,四川南充637000)【摘要】目的:比较七氟醚和异氟醚麻醉在腹腔镜胆囊切除术(1aparoscopecholecystectomy,LC)中对应激反应的影响。方法:60例ASAI一Ⅱ级择期行LC术患者随机分成七氟醚组(
2、S组)和异氟醚组(I组)。于诱导前和术后清醒时检测两组患者皮质醇(CORTISOL)及血糖(GLU)水平;同时记录诱导前(T1)、气腹前(T2)、气腹后5min(T3)、气腹后10min(T4)和苏醒时(T5)的血压和心率。结果:S组拔管时的皮质醇和血糖浓度较诱导前无明显增加(P<0.05),且较I组低。I组除气腹前血压低于诱导前外,气腹后5min、气腹后10min、苏醒时的血压和心率均高于诱导前,并且高于相应时点S组值(P<0.05)。结论:七氟醚较异氟醚更能有效的抑制LC术中应激反应,且血流动力学更平稳。【关键词】七氟醚;
3、异氟醚;腹腔镜胆囊切除术;应激反应【文章编号】1005—3697(2011)ol-0038-03【中图分类号】614.27【文献标识码】AStressResponsesofSevofluraneandIsofluraneInhaledAnesthesiainLap-aroscopeCholecystectomyYANGChang,HELin,ZUOYou.bo,YANGPing,HUYou.zhi,HUJian.hui(1.CentralHospitalofPanzhihua,Panzhihua,Sichuan617067;2
4、.AffiliatedHospitalofNorthSichuanMedicalCollege,Nanchong,Sichuan637000)【Abstract】0bjective:Toobservetheefectsofstressresponsesofsevofluraneandisofluraneinhaledanesthesiainlaparoseopechole—eysteetomy.Methods:SixtyASAI-IIpatientsarrangedforlaparoscopech0lecystect0mywe
5、rerandomlydividedintotwogroups,sevofluranegroup(Sgroup,n=3O)andisoflurauegroup(1group,n:30).Cortisoneandbloodglucoseweremeasuredbeforeanesthe—siainductionandaftersurgery.Systolicbloodpressure(SBP),meanarterialpressure(MAP),diastolicbloodpressure(DBP)andheartrate(HR)
6、wererecordedatthefollowingpoints,beforeanesthesiainduction(T1),beforepneumperitneum(T2),5minafterpneumoperit0neum(T3),10rainafterpneum0perit0neun1(T4)andtheendofoperation(T5)。Results:CortisoneandblodglucoseincreasedwerecomparedwithbeforeanesthesiainductioninSgroup,a
7、ndwerehigherthanthoseinIgroup.TheSBP,MAP,DBPandHRat5minafterpneumperitneum,10minafterpneumperitneumandtheendofoperationingroup1weresignificantlyhigherthanthoseingroupS(P<0.05orP<0.O1).Conclusions:SevofluraneisbetterthanisofluraneindepressingstressresponsesinLCanddec
8、reasingthefluctuationofhemodynamics.IKeywords】Sevo1]urane;Isoflurane;Laparoscopecho1ecys£ec£omy;Stressresponse腹腔镜胆囊切除术(LC)有创伤小、恢复快等优皮质醇的增高
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