【摘要】 目的:探讨靶控输注丙泊酚复合瑞芬太尼在腹腔镜胃癌根治术中的麻醉效果。方法:选取2015年3月至2017年2月肇庆市第一人民医院收治的择期行腹腔镜胃癌根治术的患者68例,随机分为观察组和对照组,每组34例。对照组患者给予丙泊酚复合瑞芬太尼静脉泵入,观察组患者给予丙泊酚复合瑞芬太尼靶控输注。记录两组患者麻醉诱导前（T₀）、诱导后2 min（T₁）、插管即刻（T₂）、手术开始时（T₃）和手术结束时（T₄）的平均动脉压（MAP）、心率（HR）,比较两组患者术中及术后相关指标水平、麻醉药品使用剂量及术后Ramsay评分和视觉模拟评分的差异。结果:T₁、T₂、T₃和T₄时,观察组患者MAP水平明显高于对照组;且观察组患者T₁时HR水平明显高于对照组,T₂时HR水平明显低于对照组,差异均有统计学意义（P<0.05）。观察组患者麻醉时间、自主呼吸恢复时间、拔管时间及睁眼时间明显短于对照组,差异均有统计学意义（P<0.05）。观察组患者丙泊酚、瑞芬太尼使用剂量明显低于对照组,差异均有统计学意义（P<0.05）。术后4、8 h时,观察组患者的视觉模拟评分、Ramsay评分明显低于对照组,差异均有统计学意义（P<0.05）。结论:靶控输注丙泊酚复合瑞芬太尼有助于稳定腹腔镜胃癌根治术中患者的血流动力学,且患者术后意识恢复迅速,预后较好。更多还原

【Abstract】 OBJECTIVE: To probe into the anesthetic effect of propofol combined with remifentanil for target controlled infusion in laparoscopic radical gastrectomy. METHODS: 68 patients undergoing laparoscopic radical gastrectomy admitted into the First People’s Hospital of Zhaoqing from Mar. 2015 to Feb. 2017 were selected and randomly divided into observation group and control group, with 34 cases in each group. The control group was given propofol combined with remifentanil for intravenous pump, while the observation group was given propofol combined with remifentanil for target controlled infusion. The mean arterial pressure（MAP） and heart rate（HR） of before the anesthesia induction（T₀）, 2 min after induction（T₁）, immediately after intubation（T₂）, at the beginning（T₃） and the end（T₄） of surgery were recorded. Differences in intraoperative and postoperative related indices, doses of anesthetic, postoperative Ramsay scores and visual analogue scales（VAS） between two groups were compared. RESULTS: At T₁, T₂, T₃ and T₄, the MAP level of observation group was significantly higher than that of the control group; the HR level of observation group was significantly higher than that of the control group at T₁, while it was significantly lower than that of the control group at T₂, with statistically significant difference（P<0.05）. The anesthesia time, recovery time of autonomous respiration, extubation time and awakening time of observation group were significantly shorter than those of the control group, with statistically significant difference（P<0.05）. The doses of propofol and remifentanil of observation group were significantly lower than those of the control group, with statistically significant difference（P<0.05）. At 4 h and 8 h after surgery, the VAS and Ramsay scores of observation group were significantly lower than those of the control group, with statistically significant difference（P<0.05）. CONCLUSION: Target controlled infusion of propofol combined with remifentanil is helpful in stabilizing hemodynamics in patients undergoing laparoscopic radical gastrectomy, with rapid postoperative consciousness recovery and well prognosis.更多还原