【摘要】 目的　观察新吸入麻醉药七氟醚对腹腔镜胆囊摘除术全麻下患者血流动力学的影响。方法　对 2 0例胆囊结石或胆囊息肉患者施行静脉全麻 ,用七氟醚作吸入麻醉药维持麻醉 ,分别记录每例患者诱导麻醉时、诱导麻醉后、吸七氟醚 5min后、手术开始前、气腹后、胆囊切除后以及术毕时的心率 (HR ,次 /min)、平均动脉压 (MAP ,KPa)、中心静脉压(CVP ,KPa)、肺动脉压 (PAP ,KPa)、每搏量 (SV ,ml/beat)、每搏指数 (SI ,ml/m2 )、心输出量 (CO ,L/min)、心指数 (CI,Lmin 1 /m2 )及每搏量比率 (SVR ,dyn·s 1 /cm5)。结果　 2 0例病人诱导麻醉前、后各血流动力学指标变化不明显。吸入七氟醚5min ,SV及SI明显高于诱导麻醉前 (P <0 .0 5 ,P <0 .0 1) ;气腹后SV和SI则下降并接近诱导麻醉前水平。吸入七氟醚5min后、气腹后及胆囊切除后 ,MAP均明显低于诱导麻醉前 (P <0 .0 5 ) ,到术毕时接近诱导麻醉前水平。结论　七氟醚用于腹腔镜手术麻醉安全可靠 ,能有效减轻CO2 气腹对患者血流动力学的影响。更多还原

【Abstract】 Objective To investigate the effects of inhalation anesthetic sevoflurane on hemodynamics during laparoscopic cholecystectomy.Methods Twenty patients with cholelithiasis or gallbladder polypus received intravenous anesthesia,inhalation anesthetic sevoflurane was as the maintenance anesthetic.The heart rate (HR,bpm),mean arterial pressure (MAP,kpa),central venous pressure (CVP,kpa),pulmonary arterial pressure (PAP,kpa),stroke volume (SV,ml/beat),systolic index (SI,ml/m2),cardiac output (CO,L/min),cardiac index (CI,Lmin -1/m2) and stroke volume ratio (SVR,dyn·s -1/cm5) of patients wear recorded before and after induction,five minutes after inhalation sevoflurane,after pneumoperitoneum,before,during and after operation.Results The changes of hemodynamics in this patients wear no significant difference before and after induction.The SV and SI of five minutes after inhalation sevoflurane wear higher than that before induction (P<0.05,P<0.01).The SV and SI between after pneumoperitoneum and before induction wear no significant difference (P>0.05).The MAP in five minutes after inhalation sevoflurane,after pneumoperitoneum,and after cholecystectomy was higher than that before induction (P<0.05).The MAP between before induction and after operation was no significant difference (P>0.05).Conclusion It is safe to use sevoflurane during laparoscopic cholecystectomy.It can reduce impact of CO 2 pneumoperitoneum on hemodynamics.更多还原