【摘要】 目的 探讨不同剂量羟考酮对瘢痕子宫再次妊娠行子宫动脉栓塞联合宫腔镜下刮宫术患者麻醉效果及应激反应的影响。方法 将120例瘢痕子宫再次妊娠行子宫动脉栓塞联合宫腔镜下刮宫术患者按随机数字表法分为A组、B组、C组,各40例,均予以全麻条件下进行手术,手术结束前15 min,A组、B组、C组分别给予羟考酮0.05 mg·kg^-1、羟考酮1mg·kg^-1、0.9%生理盐水静脉滴注。手术前及术后第1 d检测3组血糖、血清皮质醇水平变化,术后记录3组麻醉效果、苏醒时间,采用疼痛视觉模拟评分法评定3组术后疼痛程度。结果 （1）手术后麻醉优良率B组>C组>A组,3组比较差异有统计学意义（P<0.05）。（2）手术后3组苏醒时间比较差异无统计学意义（P>0.05）,疼痛视觉模拟评分法评分由低到高依次为B组<A组<C组（P<0.01）。（3）手术后3组血糖、血清皮质醇水平均较手术前显著升高（P<0.05或0.01）,血糖及血清皮质醇水平由低到高依次为B组<A组<C组（P<0.05或0.01）。结论 静脉滴注羟考酮0.1 mg·kg^-1对子宫动脉栓塞联合宫腔镜下刮宫术患者的麻醉效果较好,能有效减轻患者的疼痛程度,降低应激反应,有利于患者术后恢复。更多还原

【Abstract】 Objective To investigate the effects of different doses of oxycodone on anesthesia and stress response in patients undergoing hysteroscopic curettage after uterine artery embolization.Methods 120 patients with scarred uterus who underwent uterine artery embolization combined with hysteroscopic curettage were divided into group A,group B and group C according to random number table method,40 cases each.All operations were performed under general anesthesia.15 minutes before the end of the operation,groups A,B,and C were given oxycodone 0.05 mg · kg^-1,oxycodone 1 mg·kg^-1,and 0.9% saline intravenously drip.Before operation and on the first day after operation,the changes of blood glucose and serum cortisol levels in the three groups were detected.The anesthesia effect and recovery time of the three groups were recorded postoperatively.VAS was used to assess the degree of postoperative pain in the three groups.Results（1） Postoperative anaesthesia superiority rate group B> group C> group A,the difference among the three groups was statistically significant（P<0.05）.（2） There was no significant difference in the recovery time among the three groups after the operation（P>0.05）,and the pain visual analogue scoring score group B <group A <group C（P<0.01）.（3） After surgery,the blood glucose and serum cortisol levels in the three groups were significantly higher than before the surgery（P<0.05 or0.01）,and the blood glucose and serum cortisol levels from low to high were group B <group A <group C（P<0.05 or 0.01）.Conclusions Intravenous infusion of oxycodone 0.1 mg · kg^-1 has a good anesthesia effect on patients with uterine artery embolization combined with hysteroscopic curettage.It can effectively reduce the patient’s pain and reduce the patient’s stress response,which is conducive to the patient’s recovery after surgery.更多还原