不同阿片类药物与丙泊酚联用对人工流产术患者呼吸的影响*

陈一犀胡帅

(成都中医药大学第二附属医院麻醉科, 四川 成都 610041)

【摘要】目的观察芬太尼、舒芬太尼、瑞芬太尼应用于人工流产术的效果及对患者呼吸的影响。方法选择本院于2014年1月～2014年7月收治行人工流产术患者150例作为研究对象，ASA Ⅰ-Ⅱ级，随机分为三组，A组给予丙泊酚复合芬太尼，B组给予丙泊酚复合舒芬太尼，C组给予丙泊酚复合瑞芬太尼，比较三组麻醉效果及对呼吸影响差异。结果三组丙泊酚总量无统计学差异(P>0.05)。A组、B组苏醒时间分别为(3.8±0.6)min、(3.7±0.7)min，均长于C组(P<0.05)。诱导后A组、B组SPO2分别为(95.1±1.5)%、(95.7±1.8)%，均高于C组(均P<0.05)。三组不良反应比较均无统计学差异(P>0.05)。结论芬太尼、舒芬太尼、瑞芬太尼应用于人工流产术均可以取得较佳效果，芬太尼、舒芬太尼对患者呼吸影响较小，具有重要的临床价值。

【关键词】人工流产术； 芬太尼； 舒芬太尼； 瑞芬太尼

【中图分类号】R 719.3+1【文献标志码】A

基金项目：成都市科技攻关项目 (20112PE1-2)

收稿日期：( 2014-10-08； 编辑： 张文秀)

The contrast study for respiratory effects of different opioids combined with propofol used in artificial abortion operation on patients CHEN Yixi，HU Shuai

(DepartmentofAnesthesiology,TheSecondAffiliatedHospitalofChengduUniversityofTraditional

ChineseMedicine,Chengdu610091)

Abstract【】ObjectiveTo observe the effect of fentanyl, sufentanil, remifentanil used in artificial abortion operation and influence on respiration. Methods150 artificial abortion patients were selected as the research objects, ASA I-II grade. They were randomly divided into three groups. A group was given propofol combined with fentanyl, B group was given propofol combined with sufentanil and group C were treated with propofol and remifentanil. The anesthesia effect and respiratory effects were observed.ResultsThere was no significant difference in the total amount of propofol between the three groups (P>0.05). Group A, group B 'recovery time were (3.8±0.6) min, (3.7±0.7) min and were longer than those of group C(P<0.05). After the induction group A, group B 'SPO2 respectively were (95.1±1.5)%, (95.7±1.8)% and were higher than those of group C (P<0.05). Adverse reactions of three groups had no significant difference (P>0.05). ConclusionFentanyl, sufentanil, remifentanil used in artificial abortion can achieve good anesthesia effect. Fentanyl, sufentanil has little effect on the respiratory have important value.

【Key word】Artificial abortion operation; Fentanyl; Sufentanil; Remifentanil

人工流产术为临床终止妊娠的方法之一。以往，多于无麻醉状态下进行，患者常疼痛难忍，剧烈体动，影响手术进程，甚至部分患者因剧烈疼痛等致心血管反应发生，一定程度上增加了手术风险。随着临床研究的不断深入和发展，麻醉状态下行人工流产术逐渐受到临床欢迎，麻醉状态下手术速度快，减轻患者痛苦[1-2]。随着药物发展，已有多种药物广泛应用于临床，丙泊酚及芬太尼、舒芬太尼等均广泛应用。相关研究[3]表明，单独应用丙泊酚不良反应发生率较高，用药总量较大，呼吸抑制发生率较高，一定程度上不利于患者安全。丙泊……