【摘要】 目的：对比七氟烷与丙泊酚维持麻醉对合并冠心病腹腔镜胆囊切除术（LC）患者心功能、氧化应激和术后认知功能的影响。方法：选取2020年3月～2022年4月在吉林大学第一医院乐群院区麻醉科行全麻下LC的98例合并冠心病的患者，按照随机数字表法将患者分为A组（n=49，丙泊酚维持麻醉）和B组（n=49，七氟烷维持麻醉）。对比两组麻醉效果、血流动力学相关指标[心率（HR）、平均动脉压（MAP）、血氧饱和度（SpO2）]、认知功能情况[简易智能精神状态量表（MMSE）评分]、心功能指标[心输出量（CO）、心脏指数（CI）、左室射血分数（LVEF）]、氧化应激指标[超氧化物歧化酶（SOD）、丙二醛（MDA）、总抗氧化能力（T-AOC）]和不良反应发生率。结果：B组的恢复自主呼吸时间、睁眼时间、拔管时间、定向力恢复时间均短于A组（P<0.05）。B组气腹后5 min、手术结束时SpO2、HR、MAP高于A组（P<0.05）。B组术后1 d、术后3 d MMSE评分高于A组（P<0.05）。B组术后1 d CO、CI、LVEF高于A组（P<0.05）。B组术后1d SOD高于A组，MDA、T-AOC低于A组（P<0.05）。两组不良反应发生率组间比较无统计学差异（P>0.05）。结论：与丙泊酚维持麻醉相比，七氟烷用于合并冠心病LC患者，有利于维持血流动力学稳定，减轻心功能、氧化应激损伤和术后认知功能障碍。更多还原

【Abstract】 Objective: To compare the effects of sevoflurane and propofol maintenance anesthesia on cardiac function, oxidative stress and postoperative cognitive function in patients with coronary heart disease undergoing laparoscopic cholecystectomy(LC).Methods: 98 patients with coronary heart disease who were underwent general anesthesia LC in the department of Anesthesiology, Lequn Campus of Jilin University First Hospital from March 2020 to April 2022 were selected, and patients were divided into Group A(n=49,propofol maintained anesthesia) and Group B(n=49, sevoflurane maintained anesthesia) according to the random number table method.The anesthetic effects, hemodynamic related indicators [heart rate(HR), mean arterial pressure(MAP), oxygen saturation(SpO2)], cognitive function [mini-mental state examination(MMSE) scores], cardiac function indicators [cardiac output(CO), cardiac index(CI), left ventricular ejection fraction(LVEF)], oxidative stress indicators [superoxide dismutase(SOD), malondialdehyde(MDA), total antioxidant capacity(T-AOC)] and incidence of adverse reactions were compared between two groups. Results: The recovery spontaneous breathing time, eye opening time, extubation time, and directional recovery time in Group B were shorter than those in Group A(P<0.05).The Sp O2, HR, and MAP in Group B at 5 minutes after pneumoperitoneum and at the end of surgery were higher than those in Group A(P<0.05). The MMSE scores in Group B at the 1d after surgery and 3d after surgery were higher than those in Group A(P<0.05). The CO,CI, and LVEF in Group B were higher than those in Group A at the 1d after surgery(P<0.05). The SOD in Group B was higher than that in Group A, while MDA and T-AOC were lower than those in Group A at the 1 d after surgery(P<0.05). There were no statistically significant differences in the incidence of adverse reactions between two groups(P>0.05). Conclusion: Compared with propofol for maintaining anesthesia, sevoflurane used to in patients with coronary heart disease undergoing LC is beneficial for maintaining hemodynamic stability and reducing cardiac function, oxidative stress damage, and postoperative cognitive impairment.更多还原