谢宇宁 陆立仁 杨珮

【摘要】 目的：分析丙泊酚復合瑞芬太尼在卵巢囊肿切除术中的应用及对Ramsay镇静评分的影响。方法：选取2019年1月-2020年1月在本院择期行腹腔镜卵巢囊肿切除术的卵巢囊肿患者80例，均择期行腹腔镜卵巢囊肿切除术，按照随机数字表法将其分为观察组和对照组，每组40例。对照组应用丙泊酚复合舒芬太尼麻醉镇静，观察组应用丙泊酚复合瑞芬太尼麻醉镇静。观察并比较两组麻醉前后不同时间点的生命体征情况、麻醉情况（麻醉诱导时间、术后苏醒时间、术后定向力恢复时间）、MMSE、Ramsay镇静评分及不良反应发生情况。结果：两组麻醉前、麻醉诱导后心率、平均动脉压水平比较，差异均无统计学意义（P>0.05）;但观察组插管时、插管后5 min、气腹后5 min、拔管后5 min心率、平均动脉压水平均低于对照组（P<0.05）。观察组麻醉诱导时间、术后苏醒时间、术后定向力恢复时间均明显短于对照组（P<0.05）。观察组镇静效果明显优于对照组（P<0.05）。观察组术后1 h的MMSE评分明显高于对照组（P>0.05）;两组术后3 h的MMSE评分均较高，但两组比较差异无统计学意义（P>0.05）。观察组不良反应发生率为10.00%，明显低于对照组的27.50%（P<0.05）。结论：丙泊酚复合瑞芬太尼在卵巢囊肿切除术中的应用效果较好，患者生命体征较为平稳，镇静效果较好，并发症较少，且术后认知功能恢复较快，具有临床应用价值。

【关键词】 丙泊酚 瑞芬太尼 卵巢囊肿切除术 Ramsay镇静评分 MMSE评分

Application of Propofol Combined with Remifentanil in Ovarian Cyst Resection and Its Influence on Ramsay Sedation Score/XIE Yuning， LU Liren， YANG Pei. //Medical Innovation of China， 2021， 18（12）： 0-081

[Abstract] Objective： To analyze the application of Propofol combined with Remifentanil in ovarian cyst resection and its influence on Ramsay sedation score. Method： A total of 80 patients with ovarian cysts who underwent ovarian cyst resection in our hospital from January 2019 to January 2020 were selected and randomly divided into the observation group and the control group， 40 cases in each group. The control group was given Propofol combined with Sufentanil anesthesia and sedation， and the observation group was given Propofol combined with Remifentanil anesthesia and sedation. The vital signs， anesthesia conditions （anesthesia induction time， postoperative recovery time， postoperative orientation recovery time）， MMSE， Ramsay sedation score and adverse reactions were observed and compared between two groups. Result： There were no significant differences in heart rate and mean arterial pressure between two groups before and after anesthesia induction （P>0.05）， but the heart rate and mean arterial pressure of the observation group at the time of intubation， 5 min after intubation， 5 min after pneumoperitoneum and 5 min after extubation were lower than those of the control group （P<0.05）. The anesthesia induction time， postoperative recovery time and postoperative orientation recovery time of the observation group were significantly shorter than those of the control group （P<0.05）. The sedative effect of the observation group was significantly better than that of the control group （P<0.05）. The MMSE score of the observation group at 1 h after operation was significantly higher than that of the control group （P>0.05）， and the MMSE scores at 3 h after operation in two groups were higher， but there were no statistical significances （P>0.05）. The incidence of adverse reactions in the observation group was 10.00%， it was significantly lower than 27.50% in the control group （P<0.05）. Conclusion： Propofol combined with Remifentanil in ovarian cyst resection has better effect， more stable vital signs， better sedation effect， fewer complications， and faster postoperative cognitive function recovery， which has clinical application value.

[Key words] Propofol Remifentanil Ovarian cyst resection Ramsay sedation score MMSE score

First-authors address： The Peoples Hospital of Nanhai District in Foshan City， Foshan 528200， China

doi：10.3969/j.issn.1674-4985.2021.12.018

卵巢囊肿是女性常见的一种妇科疾病，临床除采用保守治疗外，多采用卵巢囊肿切除术进行治疗，取得了较好的效果，且随着腹腔镜技术的发展，腹腔镜卵巢囊肿切除术越来越受到广大临床工作者及患者的青睐，这是由于腹腔镜卵巢囊肿切除术具有伤口小、出血量少、术后恢复较快等诸多优点[1-3]。但在腹腔镜卵巢囊肿切除术过程中，需建立二氧化碳气腹可能会影响患者的呼吸循环系统，这往往导致患者术中会出现生命体征的较大波动，影响手术效果及术后恢复状况，为此选择合适的麻醉药物对于改善上述问题意义重大[4-5]。笔者选取……