摘要
目的:探讨七氟醚预处理对腹腔镜手术患者术中呼吸循环及血清内脏蛋白水平的影响。方法:选择2015年1月至2016年12月本院收治的行腹腔镜胃肠手术患者80例,按随机数字表法分为观察组和对照组,每组40例,观察组在麻醉诱导时预先吸入1%七氟醚,对照组接受常规麻醉诱导。比较两组术中情况、气腹后呼吸循环指标、术后血清内脏蛋白水平及不良反应发生情况。结果:两组术中输液量、气腹时间及手术时间比较,差异均无统计学意义(均P>0.05);气腹后15min两组心率(HR)、收缩压(SBP)、舒张压(DBP)、动脉血氧饱和度(SpO_2)、每搏输出量(SV)、心输出量(CO)、加速指数(ACI)、体循环阻力(SVR)、气道峰压(Ppeak)较气腹前均有明显波动,观察组波动幅度小于对照组,差异有统计学意义(P<0.05)。术后2d,观察组前白蛋白(PRE)和视黄醇结合蛋白(RbP)水平均高于对照组(均P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:对腹腔镜手术患者实施七氟醚预处理安全性较高,能减少气腹压对呼吸循环的影响,降低术后血清内脏蛋白水平的下降幅度。
Objective：To investigate the effect of sevoflurane preconditioning on intraoperative respiratory circulation and the level of visceral protein in patients undergoing laparoscopic surgery.Methods：A total of80 patients who underwent laparoscopic gastrointestinal surgery in our hospital from January 2015 to December 2016 were selected,and randomly assigned to receive either 1%sevoflurane inhaled induction（observation group,n=40）or conventional anesthesia induction（control group,n=40）.The intraoperative situation,respiratory circulation,the serum level of visceral protein and the adverse reactions were observed.Results：The intraoperative infusion volume,pneumoperitoneum time and operation time were not significantly different between the two groups（P 〉0.05）.Fifteen minutes after pneumoperitoneum,the heart rate（HR）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,oxygen saturation（SpO2）,stroke volume（SV）,cardiac outcome（CO）,allowable concentration index（ACI）,systemic circulation resistance（SVR）and airway peak pressure（Ppeak）were significantly different before and after pneumoperitoneum,but these indexes were not obviously changed in the observation group（P〈0.05）.After 2 days of surgery,the prealbumin（PRE）and retinol binding protein（RbP）levels in the observation group were higher than those in the control group（P〈0.05）.No significant difference was noted in the incidence of adverse reactions between the two groups（P 〉0.05）.Conclusion：Sevoflurane preconditioning was safe in patients who underwent laparoscopic gastrointestinal surgery.It could attenuate the influence of pneumoperitoneum pressure on respiratory circulation,and inhibit the reduction of postoperative visceral protein level.
作者
王清
Wang Qing(Department of Pharmacy,Traditional Chinese Medicine Hospital in Linyi,Linyi 276001,China)
出处
《广西医科大学学报》
CAS
2018年第8期1112-1116,共5页
Journal of Guangxi Medical University
关键词
七氟醚
腹腔镜手术
呼吸循环
内脏蛋白水平
sevoflurane
laparoscopic surgery
respiratory circulation
visceral protein level
