摘要
目的探讨七氟醚和丙泊酚麻醉对子宫肌瘤切除术患者血流动力学和胰岛功能的影响。方法选取2015年4月至2018年4月于本院行腹腔镜手术治疗的子宫肌瘤患者80例,按随机数字表法分为A组和B组各40例,麻醉诱导后A组患者予以七氟醚吸入麻醉,B组予以靶控输注丙泊酚。记录两组患者麻醉前5min(T0)、麻醉后10min(T_(1))、手术开始时(T_(2))、麻醉完成后(T_(3))及手术结束时(T_(4))的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2))、呼吸末二氧化碳(PETCO_(2))、血糖、胰岛素、C肽、胰高血糖素及皮质醇水平,观察并记录两组患者并发症发生情况。结果两组患者的T_(1)~T_(4)时间点的MAP、HR、SpO_(2)、PETCO_(2)水平均高于T_(0)时间点的水平(P<0.05);在T_(1)~T_(4)时间点,两组的MAP、HR、SpO_(2)、PETCO_(2)水平比较,差异均无统计学意义(P>0.05)。与T_(0)时间点比较,两组患者的血糖、胰岛素、C肽、胰高血糖素及皮质醇水平在T_(1)~T_(4)时间点时明显升高(P<0.05),T_(1)~T_(4)时B组患者的血糖、胰高血糖素及皮质醇浓度明显低于A组(P<0.05),C肽和胰岛素水平明显高于A组患者(P<0.05),术后A组并发症发生率高于B组(P<0.05)。结论七氟醚与丙泊酚对子宫肌瘤切除术患者的血流动力学影响无较大差别,但丙泊酚更能促进胰岛素和C肽分泌,抑制皮质醇和胰高血糖素分泌,抑制术中血糖升高,并减少术后并发症发生。
Objective To explore the effects of sevoflurane and propofol anesthesia on hemodynamics and islet function in patients undergoing hysteromyomectomy.Methods 80 patients with uterine fibroids treated with laparoscopic surgery in the hospital from April 2015 to April 2018 were selected.They were divided into group A and group B by the random number table method,40 cases in each group.After anesthetic induction,group A were given inhalation anesthesia with sevoflurane,while group B were given target-controlled infusion of propofol.The mean arterial pressure(MAP),heart rate(HR),saturation of blood oxygen(SpO_(2)),end-tidal carbon dioxide(PETCO_(2)),levels of blood glucose,insulin,C-peptide,glucagon and cortisol in both groups at 5 minutes before anesthesia(T0),10 minutes after anesthesia(T_(1)),the beginning of surgery(T_(2)),after anesthesia(T_(3))and at the end of surgery(T_(4))were recorded.The occurrence of related complications was observed and recorded.Results The levels of MAP,HR,SpO_(2) and PETCO_(2) in both groups at T_(1) and T_(4) were higher than those at T_(0)(P<0.05).There were no significant differences in above indexes between the two groups between T_(1) and T_(4)(P>0.05).Compared with those at T_(0),the levels of blood glucose,insulin,C-peptide,glucagon and cortisol in both groups were significantly increased between T_(1) and T_(4)(P<0.05).The blood glucose,glucagon and cortisol concentrations in group B were significantly lower than those in group A between T_(1) and T_(4)(P<0.05),while levels of C-peptide and insulin were significantly higher than those in group A(P<0.05).The incidence of postoperative complications in group A was higher than that in group B(P<0.05).Conclusion There is no significant difference in the effect between sevoflurane and propofol on hemodynamics in patients undergoing hysteromyomectomy.However,propofol can more promote the secretion of insulin and C-peptide,inhibit secretion of cortisol and glucagon,inhibits intraoperative blood glucose elevation,and reduce occurrence of postoperative complications.
作者
刘璐璐
王明会
LIU Lu-lu;WANG Ming-hui(Department of Obstetrics and Gynecology,the First People's Hospital of Zhumadian,Zhumadian 463000,Henan Province,China)
出处
《罕少疾病杂志》
2022年第3期60-62,104,共4页
Journal of Rare and Uncommon Diseases
基金
河南省科技攻关计划项目(2017020327)。
作者简介
第一作者/通讯作者:刘璐璐,女,护师,主要研究方向:妇产科疾病的护理。E-mail:reny1980607@163.com。
