摘要
目的:分析丙泊酚麻醉对妇科微创手术病人术中皮质醇(Cor)和血糖水平的影响。方法:收集行腹腔镜下子宫肌瘤切除术治疗的病人60例,随机分为七氟醚组和丙泊酚组,各30例。七氟醚组于麻醉诱导后吸入七氟醚;丙泊酚组靶控输注丙泊酚。比较2组病人建立气腹前(T_1)和建立气腹后10 min(T_2)、30 min(T_3)及术毕(T_4)时的平均动脉压(MAP)、心率(HR)和Cor、血糖、胰岛素、C肽、胰高血糖素(Glu)水平。结果:2组病人麻醉时间、自主呼吸恢复时间、睁眼时间、拔管时间、手术时间和清醒时间差异均无统计学意义(P>0.05);术中输注胶体液量、输液总量、使用血管活性药物例数及阿片类药物使用量差异亦均无统计学意义(P>0.05)。2组病人不同时间点的MAP、HR差异均无统计学意义(P>0.05);T_2、T_3、T_4时的Cor、血糖、胰岛素、Glu水平均高于T_1(P<0.05～P<0.01)。丙泊酚组T_1时的Cor、血糖、胰岛素、C肽和Glu水平与七氟醚组差异均无统计学意义(P>0.05);T_2时血糖、Glu水平均低于七氟醚组,C肽水平高于七氟醚组(P<0.05);T_3、T_4时Cor、血糖、Glu水平均低于七氟醚组,胰岛素、C肽水平均高于七氟醚组(P<0.05～P<0.01)。结论:丙泊酚和七氟醚均可有效维持腹腔镜子宫肌瘤切除术病人术中血流动力学稳定,但丙泊酚可以促进病人术中C肽和胰岛素的分泌,抑制了术中Glu、Cor过度分泌及血糖过度升高,相较于七氟醚,丙泊酚减轻术中应激反应的效果更佳。
Objective： To analyze the effects of propofol anesthesia on the levels of cortisol（ Cor） and blood glucose in female patients treated with minimally invasive surgery. Methods： Sixty patients treated with laparoscopic myomectomy were divided into the sevoflurane group（ n = 30） and propofol group（ n = 30） according to the random number table method. After anesthesia induction,the sevoflurane was inhaled in sevoflurane group,and the propofol was infused in propofol group. The levels of mean arterial pressure（ MAP）,heart rate（ HR）,cortisol（ Cor）,blood glucose,insulin,C peptide,glucagon（ Glu） between two groups were compared at the establishment of pneumoperitoneum（ T1） and after 10 min and 30 min of pneumoperitoneum（ T2 and T3） and during surgery（ T4）. Results： The differences of the anesthesia time,opening eye time,operation time and awaking time between two groups were not statistically significant（ P〉0. 05）. The differences of the anesthesia time,opening eye time,operation time and awaking time between two groups were not statistically significant（ P〉0. 05）. The differences of the amount of colloidal fluid,total fluid infusion volume,number of vasoactive drug use and amount of opioid use between two groups were not statistically significant（ P〉0. 05）. The differences of the levels of MAP and HR between two groups at different time-points were not statistically significant（ P〉0. 05）. The levels of Cor,blood glucose,insulin,C peptide and Glu in two groups at T2,T3 and T4 were higher than those at T1（ P〈0. 05 to P〈0. 01）. At T1,the differences of the levels of Cor,blood glucose,insulin,C peptide and Glu between two groups were not statistically significant（ P〉0. 05）. At T2,the levels of blood glucose and Glu in propofol group were lower than those in sevoflurane group,and the level of C peptide in propofol group was higher than that in sevoflurane group（ P〈0. 05）. At T3 and T4,the levels of Cor,blood glucose and Glu in propofol
作者
吴强
WU Qiang(The Integrated Traditional Chinaese and Western Medicine Hospital of Dazhou,Dazhou Sichuan 635000,China)
出处
《蚌埠医学院学报》
CAS
2018年第6期741-744,748,共5页
Journal of Bengbu Medical College
