阿片受体激动药对腹腔镜手术患者血浆TXA2/PGI2的影响(1)
 |
| 第1页 |
参见附件(2049KB，3页)。
【摘要】 目的 探讨阿片受体激动药对全麻腹腔镜手术患者血流动力学及TXA2/PGI2的影响。方法 60例ASAⅠ～Ⅱ级择期行腹腔镜手术的患者随机分为芬太尼组(F组)、瑞芬太尼组(R组)和舒芬太尼组(S组)。术中即时记录MAP(平均动脉压)和HR(心率)的变化并于麻醉前(T1)、气腹前(T2)、气腹后30min(T3)和解除气腹后15min(T4)四个时点抽取静脉血测定TXA2和PGI2的稳定代谢产物TXB2和6-Keto-PGF1a的浓度,并计算两者浓度的比值。结果 MAP和HR的变化:在T1、T4时相三组间比较无差异,在T2、T3时相R组和S组较F组显著降低(P<0.05),且R组和S组比较无差异。TXB2和6-Keto-PGF1a的改变:三组在T1和T2时相TXB2和6-Keto-PGF1a的含量及其浓度的比值比较均无差异。组内比较T3和T4时相TXB2和6-Keto-PGF1a的含量均较T1显著升高(F组与R组P<0.01,S组P<0.05),两者浓度比值与T1比较,F组升高,差异有统计学意义(P<0.05)。组间比较,T1和T2时相两者浓度比值无差异,T3和T4时相R组和S组比值降低(P<0.05)。与R组比较,S组在T3和T4时相血浆TXB2和6-Keto-PGF1a的含量升高幅度较低(P<0.05),其比值在T4时相S组更接近于T1水平(P<0.05)。结论 在全凭静脉全身麻醉下,芬太尼、瑞芬太尼和舒芬太尼均可较好的维持血流动力学的稳定,三者相比,舒芬太尼可更好地维持TXA2/PGI2的平衡,从而更好地维持血流动力学的稳定,改善微循环灌注。
【关键词】
腹腔镜手术;芬太尼;TXA2/PGI2
The influence of TXAPGI2 in blood plasma of patients with opioid agonists during laparoscope
CHENG Xiao-yan, LI Xiu-hua, ZHANG Yan.Anesthesiology department of weifang People’s hospital,Shangdong 261041,China
【Abstract】 Objective To investigate the influence of TXA2/PGI2 in blood plasma of the patients with opioid agonists during laparoscope. Methods Sixty ASAⅠ～Ⅱpatients undergoing the elective laparoscopic operation were randomly divided into three groups: group fentanyl (group F)、group remifentanil (group R) and group sulfentanyl (group S), n=20 for each group. During the operation MAP and HR were recorded at sight. The contents of TXA2/PGI2 (actually the stable products of metabolism:TXB2 and 6-Keto-PGF1a) were measured by extracting the internal jugular vein blood on four moments: T1-before the anesthesia; T2-before the pneumoperitoneum; T3-30 minutes after the pneumoperitoneum; T4-15 minutes after the remove of the pneumoperitoneum. Results HR and MAP showed no marked change on the T1 and T4,but on the T2 and T3 the changes were decreased compared with group F(P<0 ......
您现在查看是摘要介绍页，详见PDF附件(2049KB，3页)。