【摘要】 目的:探究地佐辛联合丙泊酚对人工流产者生命体征、应激水平及唤醒时间的影响。方法:将2019年5月-2020年8月本院自愿要求行无痛人工流产者130例随机分为两组各65例,瑞芬太尼组给予丙泊酚联合瑞芬太尼麻醉,地佐辛组给予丙泊酚联合地佐辛麻醉。比较两组受术者唤醒时间、疼痛视觉模拟评分(VAS),应激水平[促肾上腺皮质激素(ACTH)、去甲肾上腺素(NE)、血管紧张素Ⅰ(A-Ⅰ)、皮质醇(Cor)],生命体征[血氧饱和度(SpO2)、心率(HR)、平均动脉压(MAP)]及不良反应。结果:术后两组受术者唤醒时间无差异(P>0.05),VAS评分地佐辛组低于瑞芬太尼组(P<0.05)但两组均<4分。血清ACTH、A-Ⅰ水平两组均较术前升高,但地佐辛组低于瑞芬太尼组(P<0.05);血清NE、Cor水平均低于术前,但地佐辛组高于瑞芬太尼组(P<0.05)。两组受术者麻醉前、意识消失时、宫颈口扩张时、术毕苏醒时各时间点SpO2、HR、MAP等生命体征无差异(P>0.05)。地佐辛组呼吸抑制、呕吐、恶心、心动过缓及体动反应等不良反应发生率(10.8%)低于瑞芬太尼组(26.2%)(P<0.05)。结论:地佐辛联合丙泊酚用于人工流产可在不影响受术者生命体征变化及唤醒时间基础上,可有效调节受术者应激反应,不良反应发生率降低。更多还原

【Abstract】 Objective: To explore the effect of dezocine combined with propofol for anesthesia of the women with induced abortion on their vital signs, stress level, and wake-up time. Methods: 130 women who wanted painless induced abortion were randomly divided into group A and group B(65 cases in each group). The women in group A were given propofol combined with remifentanil for anesthesia, and the women in group B were given propofol combined with dezocine for anesthesia. The wake-up time, the score of visual analogue scale(VAS) of pain, the levels of stress [adrenocorticotropic hormone(ACTH), norepinephrine(NE), angiotensin I(A-Ⅰ), cortisol(Cor)], the values of vital signs [blood oxygen saturation(SpO2), heart rate(HR), and mean arterial pressure(MAP)], and adverse reactions rate of the women were compared between the two groups. Results: There was no significant difference in postoperative wake-up time of the women between the two groups(P>0.05). The VAS score of the women in group B was significant lower than that of the women in group A(P<0.05), but the VAS score of the women in both groups were <4 points. The serum ACTH and A-Ⅰ levels of the women in both groups were significant higher than those of the women before surgery, but those of the women in group B were significant lower than those of the women in group A(P<0.05). The serum NE and COR levels of the women in both groups were significant lower than those of the women before surgery, but those of the women in group B were significant higher than those of the women in group A(P<0.05). The values of SpO2, HR, MAP, and other vital signs of the women before anesthesia, when consciousness lost, when cervix dilated, and when wake-up after surgery had no significant different between the two groups(P>0.05). The total incidence of adverse reactions, such as respiratory depression, vomiting, nausea, bradycardia, and body movement of the women in group B was 10.8%, which was significant lower than that(26.2%) of the women ingroup A(P<0.05).Conclusion:Dezocine combined with propofol for anesthesia used in induced abortion can effectively regulate the stress response of the women with lower incidence of adverse reactions,but without affecting their changes of vital signs and wake-up time.更多还原