丙泊酚复合七氟醚麻醉对肝炎肝硬化 患者术后苏醒质量的影响
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杜洪印,Email :duhongyin@medmail.com.cn,Tel :022-23626973

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Effect of Propofol and Sevoflurane intravenous-inhalation compound anesthesia on post-operative recovery quality of patients with liver cirrhosis
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    摘要:

    目的 分析肝炎肝硬化患者应用丙泊酚联合七氟醚静- 吸复合麻醉对术后苏醒质量的影响。 方法 选取2015 ~ 2017 年于天津医科大学宝坻临床学院行手术治疗的肝炎肝硬化患者72 例,依据随机原则 分为观察组和对照组。观察组予以七氟醚复合丙泊酚静- 吸复合麻醉,对照组予以丙泊酚全程静脉麻醉。于 拔管后即刻(T0)、拔管后10(T1)、30(T2)和60 min(T3)分别比较两组改良OAA/S 评分与改良Aldrete 评分。分别比较两组术后苏醒时间、自主呼吸恢复时间、拔管时间、脑电双频指数(BIS)及躁动发生率。 比较两组术后呛咳反应及恶心呕吐等相关并发症发生率的差异。结果 不同时间点的改良OAA/S 评分与改 良Aldrete 评分比较有差异(P <0.05);两组的改良OAA/S 评分及改良Aldrete 评分比较有差异(P <0.05); 两组的改良OAA/S 评分及改良Aldrete 评分变化趋势比较有差异(P <0.05)。对照组苏醒时间、自主呼吸恢 复时间、拔管时间、苏醒状态BIS 指数及躁动发生率大于观察组(P <0.05)。两组术后麻醉相关并发症发生 率比较无差异(P >0.05)。结论 丙泊酚联合七氟醚静- 吸复合麻醉用于肝炎肝硬化患者手术麻醉,可以提 高术后的苏醒质量,苏醒较迅速,且安全性较好。

    Abstract:

    Objective To analyze the effect of Propofol and Sevoflurane intravenous-inhalation compound anesthesia on post-operative recovery quality of patients with liver cirrhosis. Methods Seventy-two patients diagnosed as liver cirrhosis who underwent partial hepatic resection in Baodi Clinical College of Tianjin Medical University between 2015 and 2017 were chosen and randomly divided into two groups. Each group had 36 cases. The patients of the control group accepted total Propofol anesthesia by intravenous infusion, and the patients of the observation group were given Propofol and Sevoflurane intravenous-inhalation compound anesthesia. The modified OAA/S score and the modified Aldrete score were recorded and compared between the two groups immediately after extubation (T0), and 10 (T1), 30 (T2) and 60 min (T3) after extubation. The post-operative indexes of recovery time, spontaneous respiration recovery time, extubation time, bispectral index (BIS) and agitation occurrence were compared between the two groups. The incidences of post-operative complications such as cough response and nausea and vomiting were compared between the two groups. Results The modified OAA/S score and the modified Aldrete score were different at different time points (P < 0.05). The modified OAA/S score and the modified Aldrete score were different between the two groups (P < 0.05). Compared to the control group, the modified OAA/S score and the modified Aldrete score were higher in the observation group (P < 0.05). The variation trends of the modified OAA/S score and the modified Aldrete score in the two groups were different (P < 0.05). The recovery time, spontaneous respiration recovery time and extubation time in the observation group were shorter, the BIS and agitation occurrence in the observation group were lower than those in the control group (P < 0.05). The incidences of anesthesia-related complications were not significantly different between the two groups (P > 0.05). Conclusions The intravenous-inhalation compound anesthesia with Propofol and Sevoflurane can improve the recovery quality and the safety is perfect.

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李德强,尹立军,陈学军,杜洪印.丙泊酚复合七氟醚麻醉对肝炎肝硬化 患者术后苏醒质量的影响[J].中国现代医学杂志,2018,(20):84-88

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  • 收稿日期:2017-06-02
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  • 在线发布日期: 2018-07-20
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