曾建峰

[摘要] 目的 比较瑞芬太尼复合丙泊酚靶控输注全凭静脉麻醉与七氟醚吸入麻醉的效果。 方法 选择2013年1月～2015年6月在我院择期行妇科腹腔镜子宫肌瘤剥除术的患者64例，随机分为观察组、对照组，各32例。观察组采用瑞芬太尼复合丙泊酚靶控输注全凭静脉麻醉，对照组采用七氟醚吸入麻醉。比较两组不同时间点的血流动力学指标以及术后恢复情况。 结果 观察组患者围术期血压平稳，各个时间点的收缩压、舒张压、心率与T0时比较差异均无统计学意义（P>0.05），对照组患者的收缩压、舒张压、心率在T1、T3时明显高于T0及观察组患者（P<0.05）。观察组患者术毕清醒时间、拔管时间明显短于对照组（P<0.05）。 结论 瑞芬太尼复合丙泊酚靶控输注全凭静脉麻醉，患者的血流动力学稳定，麻醉效果好，清醒时间短，值得临床推广应用。

[关键词] 瑞芬太尼；丙泊酚；靶控输注；全凭静脉麻醉；七氟醚；吸入麻醉

[中图分类号] R614.2+4 [文献标识码] A [文章编号] 1674-4721（2016）03（b）-0126-03

[Abstract] Objective To compare the effect of remifentanil combined with propofol target-controlled infusion total intravenous anesthesia and sevoflurane inhalation anesthesia. Methods 64 patients scheduled for gynecological laparoscopic uterine flesh tumour removal operation from January 2013 to July 2015 in our hospital were selected，and they were randomly divided into observation group （n=32） and control group （n=32）.Observation group was given remifentanil combined with propofol target-controlled infusion total intravenous anesthesia while ccontrol group was given sevoflurane inhalation anesthesia.Hemodynamic index at different times and postoperative recovery between two groups was compared respectively. Results Perioperative blood pressure of patients in observation group was stable，systolic blood pressure，diastolic blood pressure and heart rate at different times had no statistical difference compared with T0 （P>0.05）.Systolic blood pressure，diastolic blood pressure and heart rate in control group at T1 and T3 was obviously higher than that at T0 and the patients in observation group respectively （P<0.05）.The awake time after operation and extubation time of patients in observation group was obviously shorter than that of control group （P<0.05）. Conclusion Remifentanil combined with propofol target-controlled infusion total intravenous anesthesia，hemodynamics of patients is stable，and its anesthesia effect is good，awake time is short.It is worthy of clinical promotion and application.

[Key words] Remifentanil；Propofol；Target-controlled infusion；Total intravenous anesthesia；Sevoflurane；Inhalation anesthesia

子宫肌瘤是女性生殖系统最常见的良性肿瘤。妇科腹腔镜子宫肌瘤剥除术在临床已得到广泛开展，腹腔镜手术虽属微创手术，较传统手术方式创伤小、手术时间短，术后疼痛轻、恢复快，但由于腹腔内压力骤然增加，压迫腹腔内脏和下腔静脉，导致回心血量减少，使机体产生一系列病理、生理改变，甚至造成更严重的心血管疾病，因此本研究比较瑞芬太尼复合丙泊酚靶控输注全凭静脉麻醉及七氟醚吸入麻醉在妇科腹腔镜子宫肌瘤剥除术中的应用效果，旨在选择合适的麻醉方法，在保持术中麻醉时血流动力学稳定的同时减轻应激反应[1-3]。

1 资料与方法

1.1 一般资料

选择我院2013年1月～2015年6月择期行妇科腹腔镜子宫肌瘤剥除术的患者共64例，美国麻醉医师学会分级Ⅰ、Ⅱ级，年龄20～56岁，平均（31.3±8.9）岁，平均身高（156.7±6.8）cm，平均体重（65.5±8.6）kg。所有……