殷占君 蔡展飛 莊麗麗

[摘要] 目的 探討接受腹腔鏡手術(shù)治療的老年冠心病患者麻醉維持中丙泊酚全憑靜脈麻醉與七氟烷靜吸復(fù)合麻醉的應(yīng)用。 方法 回顧性選取2019年1月至2020年1月本院接受腹腔鏡手術(shù)治療的老年冠心病患者100例，依據(jù)麻醉維持方法分為七氟烷靜吸復(fù)合麻醉組與丙泊酚全憑靜脈麻醉組，每組各50例，統(tǒng)計(jì)分析兩組患者的血流動(dòng)力學(xué)、血管活性藥物應(yīng)用情況、心電圖ST-T異常情況、心律失常發(fā)生情況、麻醉時(shí)間、術(shù)后恢復(fù)時(shí)間、補(bǔ)液量、尿量、認(rèn)知功能。 結(jié)果 T2、T3、T4時(shí)七氟烷靜吸復(fù)合麻醉組患者的心率、平均動(dòng)脈壓均低于丙泊酚全憑靜脈麻醉組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。七氟烷靜吸復(fù)合麻醉組患者的多巴胺、阿托品、去甲腎上腺素應(yīng)用率均低于丙泊酚全憑靜脈麻醉組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。七氟烷靜吸復(fù)合麻醉組患者的心電圖ST-T異常率為14.00%（7/50），低于丙泊酚全憑靜脈麻醉組的34.00%（17/50），差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。七氟烷靜吸復(fù)合麻醉組患者的心律失常發(fā)生率為4.00%（2/50），低于丙泊酚全憑靜脈麻醉組的18.00%（9/50），差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 接受腹腔鏡手術(shù)治療的老年冠心病患者麻醉維持中七氟烷靜吸復(fù)合麻醉的應(yīng)用效果較丙泊酚全憑靜脈麻醉好。

[關(guān)鍵詞] 腹腔鏡手術(shù);老年;冠心病;丙泊酚靜脈麻醉;七氟烷靜吸復(fù)合麻醉;血流動(dòng)力學(xué);認(rèn)知功能

[中圖分類號(hào)] R541.4? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] B? ? ? ? ? [文章編號(hào)] 1673-9701（2021）24-0141-04

Application of sevoflurane intravenous-inhalation anesthesia and propofol intravenous anesthesia in elderly patients with coronary heart disease undergoing laparoscopic surgery

YIN Zhanjun? ?CAI Zhanfei? ?ZHUANG Lili

Department of Anesthesiology， Tianjin Ninghe District Hospital， Tianjin? ?300000， China

[Abstract] Objective To explore the application of propofol intravenous anesthesia and sevoflurane intravenous-inhalation anesthesia in the maintenance of anesthesia in elderly patients with coronary heart disease undergoing laparoscopic surgery. Methods A total of 100 elderly patients with coronary heart disease who received laparoscopic surgery in our hospital from January 2019 to January 2020 were retrospectively selected and divided into sevoflurane intravenous-inhalation anesthesia group and propofol total intravenous anesthesia group according to anesthesia maintenance method， 50 cases in each group. The hemodynamics， application of vasoactive drugs， ECG ST-T abnormalities，the occurrence of arrhythmia，anesthesia time，postoperative recovery time，fluid volume，urine volume，and cognitive function were statistically analyzed between the two groups. Results The heart rate and mean arterial pressure of the sevoflurane intravenous-inhalation anesthesia group were lower than those of the propofol intravenous anesthesia group at T2， T3 and T4， and the differences were statistically significant（P<0.05）. The application rates of dopamine，atropine，and norepinephrine in the sevoflurane intravenous-inhalation anesthesia group were lower than those in the propofol intravenous anesthesia group， and the differences were statistically significant（P<0.05）. The abnormal rate of ST-T in ECG was 14.00%（7/50） in the sevoflurane intravenous-inhalation anesthesia group， which was lower than 34.00% （17/50） in the propofol intravenous anesthesia group， and the difference was statistically significant（P<0.05）. The incidence of arrhythmia in patients in the sevoflurane intravenous-inhalation anesthesia group was 4.00%（2/50） lower than 18.00% （9/50） in the propofol intravenous anesthesia group， and the difference was statistically significant（P<0.05）. Conclusion Sevoflurane intravenous-inhalation anesthesia is more effective than propofol intravenous anesthesia in the maintenance of anesthesia in elderly patients with coronary heart disease undergoing laparoscopic surgery.