七氟醚和异氟醚麻醉在腹腔镜手术中对应激反应的影响.pdf

第26卷第1期川北医学院学报Vo1．26．NO．1
JOURNALOFNORTHSICHUANMEDICALCOLLEGEFeb．20Il
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七氟醚和异氟醚麻醉在腹腔镜手术中对应激反应的影响

杨昶，何林，左友波，杨平，胡有智，胡建会
(1．攀枝花市中心医院，四川攀枝花617067；2．川北医学院附属医院，四川南充637000)

【摘要】目的：比较七氟醚和异氟醚麻醉在腹腔镜胆囊切除术(1aparoscopecholecystectomy，LC)中对应激反应的影响。方
法：60例ASAI一Ⅱ级择期行LC术患者随机分成七氟醚组(S组)和异氟醚组(I组)。于诱导前和术后清醒时检测两组患
者皮质醇(CORTISOL)及血糖(GLU)水平；同时记录诱导前(T1)、气腹前(T2)、气腹后5min(T3)、气腹后10min(T4)和苏醒
时(T5)的血压和心率。结果：S组拔管时的皮质醇和血糖浓度较诱导前无明显增加(P<0．05)，且较I组低。I组除气腹前血
压低于诱导前外，气腹后5min、气腹后10min、苏醒时的血压和心率均高于诱导前，并且高于相应时点S组值(P<0．05)。结
论：七氟醚较异氟醚更能有效的抑制LC术中应激反应，且血流动力学更平稳。
【关键词】七氟醚；异氟醚；腹腔镜胆囊切除术；应激反应
【文章编号】1005—3697(2011)ol-0038-03【中图分类号】614．27【文献标识码】A

StressResponsesofSevofluraneandIsofluraneInhaledAnesthesiainLap-
aroscopeCholecystectomy

YANGChang，HELin，ZUOYou．bo，YANGPing，HUYou．zhi，HUJian．hui
(1．CentralHospitalofPanzhihua，Panzhihua，Sichuan617067；2．AffiliatedHospitalofNorthSichuanMedicalCollege，Nanchong，
Sichuan637000)

【Abstract】0bjective：Toobservetheefectsofstressresponsesofsevofluraneandisofluraneinhaledanesthesiainlaparoseopechole—

eysteetomy．Methods：SixtyASAI-IIpatientsarrangedforlaparoscopech0lecystect0mywererandomlydividedintotwogroups，

sevofluranegroup(Sgroup，n=3O)andisoflurauegroup(1group，n：30)．Cortisoneandbloodglucoseweremeasuredbeforeanesthe—
siainductionandaftersurgery．Systolicbloodpressure(SBP)，meanarterialpressure(MAP)，diastolicbloodpressure(DBP)and
heartrate(HR)wererecordedatthefollowingpoints，beforeanesthesiainduction(T1)，beforepneumperitneum(T2)，5minafter
pneumoperit0neum(T3)，10rainafterpneum0perit0neun1(T4)andtheendofoperation(T5)。Results：Cortisoneandblodglucose

increasedwerecomparedwithbeforeanesthesiainductioninSgroup，andwerehigherthanthoseinIgroup．TheSBP，MAP，DBPand

HRat5minafterpneumperitneum，10minafterpneumperitneumandtheendofoperationingroup1weresignificantlyhigherthan
thoseingroupS(P<0．05orP<0．O1)．Conclusions：SevofluraneisbetterthanisofluraneindepressingstressresponsesinLCand

decreasingthefluctuationofhemodynamics．
IKeywords】Sevo1]urane；Isoflurane；Laparoscopecho1ecys￡ec￡omy；St