七氟醚复合麻醉、异丙酚复合麻醉对妇科腹腔镜手术患者脑氧饱和度的影响(1)
【摘要】 目的：探討七氟醚复合麻醉、异丙酚复合麻醉对妇科腹腔镜手术患者脑氧饱和度的影响。方法：选择2014年12月-2016年6月在本院接受腹腔镜手术治疗的128例妇科疾病患者，按照随机数字表法分为试验组与对照组，试验组采取七氟醚复合麻醉，对照组采取异丙酚复合麻醉，比较两组患者不同时间点的rSO2值、rSO2的变化及血液流动学指标。结果：两组患者T2～T6各时间点的rSO2值较手术前均出现明显降低，组内比较差异均有统计学意义(P<0.05);试验组各时间点的rSO2值均高于对照组，但两组比较差异均无统计学意义(P>0.05)。试验组rSO2≤45%率、rSO2≤45%总持续时间、rSO2≤45%最长持续时间、rSO2≤45%整合值均显著小于对照组(P<0.05)。两组患者经不同麻醉剂诱导后，相对于T1，试验组在T2、T3时SBP、HR、MAP指标均下降微小，比较差异均无统计学意义(P>0.05);而对照组T2后HR、MAP均显著下降，T3时迅速回升，T4后又逐渐回降，不同时间点比较差异均有统计学意义(P<0.05);试验组T3、T4、T5、T6、T7后的SBP、HR和MAP均低于对照组(P<0.05);而SpO2在整个手术过程中均无显著变化，差异无统计学意义(P>0.05)。结论：在妇科腹腔镜手术中，异丙酚复合麻醉能够引起rSO2较大程度降低，而七氟醚复合麻醉使rSO2下降程度较小，有利于术中脑氧供需平衡，且对血流动力学、心率影响较小，麻醉维持更稳定。
【关键词】 七氟醚; 异丙酚; 复合麻醉; 妇科腹腔镜手术; 脑氧饱和度
【Abstract】 Objective：To investigate the effects of Sevoflurane combined anesthesia and Propofol anesthesia on cerebral oxygen saturation in patients undergoing gynecologic laparoscopic surgery.Method：A total of 128 patients with gynecological diseases who underwent laparoscopic surgery in our hospital from December 2014 to June 2016 were randomly divided into the experimental group and the control group.The experimental group was treated with Sevoflurane anesthesia，the control group was treated with Propofol combined anesthesia.The rSO2 value，rSO2 changes and hemodynamics indexes were compared between two groups at different time points.Result：The rSO2 values of T2-T6 at each time point were significantly lower than those of before operation，the differences between two groups were statistically significant(P<0.05).The rSO2 values of the experimental group were higher than those of the control group at each time point，however there were no significant differences between two groups(P>0.05).The experimental group rSO2≤45% rate，rSO2≤45% total duration，rSO2≤45% longest duration，rSO2≤45% integrated value were significantly smaller than those of the control group(P<0.05).After induction by different anesthetics，the SBP，HR and MAP indexes of T1 and T3 decreased slightly in the experimental group compared with T1，there were no significant differences between two groups(P>0.05).However，in the control group，HR and MAP were significantly decreased after T2，rapidly increased after T3，and then gradually decreased after T4，with statistically significant differences at different time points(P<0.05).After T3，T4，T5，T6，T7，the SBP，HR and MAP of the experimental group were lower than those of the control group(P<0.05).There was no significant change in SpO2 during the whole operation(P>0.05).Conclusion：In gynecological laparoscopic surgery，Propofol combined anesthesia can cause a large decrease in rSO2，while Sevoflurane combined anesthesia reduces the degree of rSO2，which is beneficial to the balance of intraoperative cerebral oxygen supply and demand，and hemodynamics，the heart rate is less affected and the anesthesia is maintained more stable., http://www.100md.com(安宁 董文理 王伟)
【关键词】 七氟醚; 异丙酚; 复合麻醉; 妇科腹腔镜手术; 脑氧饱和度
【Abstract】 Objective：To investigate the effects of Sevoflurane combined anesthesia and Propofol anesthesia on cerebral oxygen saturation in patients undergoing gynecologic laparoscopic surgery.Method：A total of 128 patients with gynecological diseases who underwent laparoscopic surgery in our hospital from December 2014 to June 2016 were randomly divided into the experimental group and the control group.The experimental group was treated with Sevoflurane anesthesia，the control group was treated with Propofol combined anesthesia.The rSO2 value，rSO2 changes and hemodynamics indexes were compared between two groups at different time points.Result：The rSO2 values of T2-T6 at each time point were significantly lower than those of before operation，the differences between two groups were statistically significant(P<0.05).The rSO2 values of the experimental group were higher than those of the control group at each time point，however there were no significant differences between two groups(P>0.05).The experimental group rSO2≤45% rate，rSO2≤45% total duration，rSO2≤45% longest duration，rSO2≤45% integrated value were significantly smaller than those of the control group(P<0.05).After induction by different anesthetics，the SBP，HR and MAP indexes of T1 and T3 decreased slightly in the experimental group compared with T1，there were no significant differences between two groups(P>0.05).However，in the control group，HR and MAP were significantly decreased after T2，rapidly increased after T3，and then gradually decreased after T4，with statistically significant differences at different time points(P<0.05).After T3，T4，T5，T6，T7，the SBP，HR and MAP of the experimental group were lower than those of the control group(P<0.05).There was no significant change in SpO2 during the whole operation(P>0.05).Conclusion：In gynecological laparoscopic surgery，Propofol combined anesthesia can cause a large decrease in rSO2，while Sevoflurane combined anesthesia reduces the degree of rSO2，which is beneficial to the balance of intraoperative cerebral oxygen supply and demand，and hemodynamics，the heart rate is less affected and the anesthesia is maintained more stable., http://www.100md.com(安宁 董文理 王伟)