摘要
目的:分析七氟醚复合瑞芬太尼静吸麻醉对老年腹腔镜胆囊切除患者的效果。方法:选取2021年6月-2022年6月长垣市人民医院收治的86例老年腹腔镜胆囊切除患者作为研究对象,依据随机数表法分为对照组(43例)和观察组(43例)。对照组行丙泊酚复合瑞芬太尼靶控输注麻醉,观察组行七氟醚复合瑞芬太尼静吸麻醉。对比两组患者术后恢复情况、血流动力学、应激反应、认知功能、不良反应。结果:观察组患者自主呼吸恢复时间、定向力恢复时间短于对照组,差异有统计学意义(t=15.946、7.531,P<0.05);T1、T2,观察组患者心率(HR)、呼吸频率(RR)、平均动脉压(MAP)高于对照组,差异有统计学意义(t=9.917、5.530;11.788、6.424;11.931、5.587,P<0.05);T1、T2,观察组患者皮质醇(Cor)、去甲肾上腺素(NE)、肾上腺素(E)低于对照组,差异有统计学意义(t=12.354、16.659;6.108、5.821;13.925、13.494,P<0.05);术后1h、术后3h,观察组患者MMSE评分高于对照组,差异有统计学意义(t=9.997、5.027,P<0.05);两组患者不良反应情况比较,差异无统计学意义(χ^(2)=0.453,P>0.05)。结论:七氟醚复合瑞芬太尼静吸麻醉在老年腹腔镜胆囊切除患者中作用明显,可保持术中血流动力学、减轻应激反应、加快术后认知功能恢复,且无严重不良反应。
Objective:To analyze the effect of sevoflurane combined with remifentanil on elderly patients undergoing laparoscopic cholecystectomy.Methods:86 elderly patients with laparoscopic cholecystectomy admitted to the hospital from June 2021 to June 2022 were randomly divided into control group(43 cases)and observation grou(43 cases).The control group was anesthetized by target-controlled infusion of propofol and remifentanil,while the observation group was anesthetized by sevoflurane and remifentanil.The postoperative recovery,hemodynamics,stress response,cognitive function and adverse reactions were compared between the two groups.Results:The recovery time of spontaneous respiration and orientation in the observation group was shorter than that in the control group,and the difference was statistically significant(t=15.946,7.531;P<0.05).At T1 and T2,HR,RR and MAP in observation group were higher than those in control group,and the difference was statistically significant(t=9.917,5.530;11.788,6.424;11.931,5.587;P<0.05).At T1 and T2,Cor,NE and E in the observation group were lower than those in the control group,and the difference was statistically significant(t=12.354,16.659;6.108,5.821;13.925,13.494;P<0.05).At 1 h and 3 h after surgery,MMSE scores in the observation group were higher than those in the control group,and the difference was statistically significant(t=9.997,5.027;P<0.05).There was no significant difference in adverse reactions between the two groups(χ^(2)=0.453,P>0.05).Conclusion:Sevoflurane combined with remifentanil has an obvious effect on the elderly patients undergoing laparoscopic cholecystectomy.It can stabilize the hemodynamics during the operation,and decrease a mild surgical stress response,and accelerate the recovery of their postoperative cognitive function without severe adverse reactions.
作者
赵卫卫
李艳
曹伟华
Zhao Weiwei;Li Yan;Cao Weihua(Department of Anesthesia,Changyuan Peo-ple’s Hospital,Changyuan,Henan,453400,China)
出处
《黑龙江医学》
2024年第9期1041-1044,共4页
Heilongjiang Medical Journal
关键词
腹腔镜胆囊切除术
老年
七氟醚
瑞芬太尼
静吸麻醉
血流动力学
应激反应
Laparoscopic cholecystectomy
The elderly
Sevoflurane
Remifentanil
Inhalation anesthesia
Hemodynamics
Stress response
