冠心病患者腹腔镜胆囊切除术围麻醉期管理

目的研究冠心病患者腹腔镜胆囊切除术(LC)围麻醉期管理。方法142例冠心病患者行LC术,选择依托咪酯、芬太尼静脉全麻,根据对血压、心率、心电监测结果,给予硝酸甘油、艾司诺尔等处理以维持血流动力学平稳。结果135例患者停药后5m in清醒,呼吸功能和肌张力恢复,7例患者10m in清醒,恢复呼吸功能和肌张力,142例患者围麻醉期心血管系统平稳,无一例发生心衰,心肌梗塞,室性心律失常和麻醉意外等并发症。术毕恢复良好。结论以芬太尼、依托咪酯麻醉药物为主,术中适当降低CO2气腹压力,充分供氧,酌情使用硝酸甘油、艾司洛尔,对保持心血管系统的稳定有一定的作用。LC对患者的创伤及刺激均较小,手术时间也较短,维持一定深度的麻醉即可完成手术。     

全凭静脉气管插管全身麻醉在腹腔镜胆囊切除术的临床研究

目的:探讨异丙酚、瑞芬太尼、万可松复合全凭静脉气管插管全身麻醉在腹腔镜胆囊切除术(LC)的临床应用。方法:50例LC患者全部采用异丙酚、瑞芬太尼、万可松复合全凭静脉气管插管全身麻醉。监测麻醉前、诱导后、插管后3min、气腹后10min、拔管前1min、拔管后3min的HR、MAP、SpO2变化,记录患者麻醉后清醒时间以及麻醉中知晓情况。结果:13例患者表现出较明显的心率减慢及血压下降,与透导前有显著改变(P<0.05),气管插管3min后心率、血压多能自动恢复正常,所有患者麻醉维护过程中HR、MAP、SpO2无显著变化(P>0.05)。麻醉后3min内36例(70％)完全清醒,5min内所有患者完全清醒。术后1例(2％)诉术中轻度知晓(P>0.05)。结论:异丙酚、瑞芬太尼、万可松复合全凭静脉气管插管全身麻醉对于LC来说是一种安全、有效、可靠的麻醉方法。     

不同麻醉方法用于胸科手术患者的效果

目的探讨胸科手术不同麻醉方法的效果。方法择期拟行胸科手术患者90例,性别不限,年龄18～65岁,ASA分级Ⅱ或Ⅲ级。采用随机数字表法,将患者分为2组(n=45):静吸复合全麻组(Ⅰ组)和全麻联合硬膜外麻醉组(Ⅱ组)。Ⅰ组麻醉诱导后,吸入七氟醚,持续输注丙泊酚维持麻醉;Ⅱ组先采取硬膜外麻醉,麻醉平面稳定后全麻诱导,吸入七氟醚维持麻醉。于术前30 min时、术中10 min时、术后10 min时记录患者的SBP、MAP、DBP、HR、SpO2。术毕记录患者气管导管拔管时间、自主呼吸恢复时间及完全清醒时间,并记录气管导管拔管即刻(T1)、拔管后5 min(T2)、10 min(T3)及20 min(T4)的RSS镇静评分。结果与Ⅰ组比较,Ⅱ组术中及术后10 min时SBP、MAP、DBP和HR降低,自主呼吸恢复时间、拔管时间及完全清醒时间显著缩短,T1-4时RSS镇静评分明显升高(P0.05)。结论全麻联合硬膜外麻醉用于胸科手术的效果优于静吸复合麻醉。     

肥胖患者腹腔镜胆囊切除术127例麻醉分析

腹腔镜手术中呼吸、循环改变与CO2气腹压力、PaCO2升高程度及体位改变有直接相关性。肥胖患者胸顺应性降低,膈肌升高,胸廓及膈肌运动受限,腹腔镜手术可能对肥胖患者呼吸循环功能产生更大的影响。本文回顾性分析我院2005年8月～2010年2月127例肥胖患者行腹腔镜胆囊切除术（1aparoscopic cholecystectomy,LC）术中的麻醉管理,旨在探讨肥胖患者LC的麻醉特点。     

成人麻醉后在恢复室内发生的低氧血症

作者选择173例择期全麻手术的成年病人,ASA1～3级,年龄均超过40岁,气管内插管和实施正压通气。不包括术后需持续吸O_2或正压通气者,也排除呼吸调控有问题或贫血、低血压导致氧饱和度仪读数不准者。从手术室到麻醉后恢复室(PACU)只呼吸空气。到达PACU后即用Hudson面罩吸O_2 10L/min,30min后按照病人已清醒,肌张力正常,生命体征无异常,也无呼吸窘迫,即终止吸O_2,约45min后即可回病房。病人到达PACU 5min后开始用Nellcor—N100型脉搏血氧饱和度仪监测直到回病房。凡氧合血红蛋白饱和度(SpO_2)低于90％,持续15秒以上定为低氧血症。出现低氧血症期间还记录呼吸频率(RR)、呼吸型式、有无中心性发绀、最低SpO_2值,以及低氧血症持续时间和意识状态(     

面部激光溶脂手术的麻醉处理

目的探讨面部激光溶脂手术的麻醉方法及效果。方法选择ASAI、Ⅱ级面部激光溶脂手术患者20例,入室后患者仰卧,静脉注射芬太尼2μg／k、丙泊酚2．0～2．5mg／kg诱导,插入喉罩,行IPPV模式控制呼吸,维持气道压20kPa以内,术中以微量泵持续泵入丙泊酚、瑞芬太尼维持麻醉,手术结束前10min停药,待患者清醒后拔出喉罩;消毒铺巾后利用肿胀技术行面部肿胀麻醉。结果全部患者麻醉顺利,效果满意,血流动力学平稳,术后清醒时间为5～15min,术后感觉舒适,无明显不良反应。结论丙泊酚复合瑞芬太尼全凭静脉麻醉联合局部肿胀麻醉在喉罩通气下用于面部激光溶脂手术简单、安全、易行。     

三种麻醉方法用于腹腔镜胆囊切除术的临床研究

目的 :探讨静脉全身麻醉、连续硬膜外麻醉和两者结合应用等 3种麻醉方法用于腹腔镜胆囊切除术 (LC)的麻醉管理对循环、呼吸及围手术期清醒质量的影响。方法 :将LC 6 0例分为 3组。静脉全麻组(GA组 ) ,连续硬膜外麻醉组 (CEA组 )和全麻复合硬膜外麻醉组 (GA +CEA) ,于麻醉前、麻醉后、气腹后5min、术毕纪录MAP、HR、Peek、PetCO2 、SpO2 、SEF ,以及呼之睁眼时间、拔管时间、术后恶心呕吐 (PONV)发生例数及术后 8h内的平均VAS评分、GA组和GA/CEA组异丙酚的平均用量。结果 :CEA组麻醉后MAP下降明显 ,GA和CEA组CO2 人工气腹后Peek、HR、MAP、PetCO2 明显增加 (p <0 0 5 ) ,CEA组SpO2 下降。术中GA/CEA组SEF大于GA组、且围手术期清醒质量较好。结论 :在腹腔镜胆囊切除术麻醉中 ,全麻复合硬膜外麻醉对循环和呼吸干扰小 ,清醒质量高且经济安全     

胸部手术实施全身麻醉联合硬膜外麻醉的效果观察

目的观察分析胸部手术实施全身麻醉联合硬膜外麻醉的效果。方法将42例SASⅠ~Ⅱ级胸部手术患者随机分为两组,各21例。对照组实施全身麻醉,观察组予以全身麻醉联合硬膜外麻醉,观察分析两组麻醉效果。结果 42例患者停止麻药后,自主呼吸恢复时间5~10 min。观察组患者麻醉药剂量明显少于对照组,且清醒时间早,两组比较,差异有统计学意义(P0.05)。结论采用全身麻醉联合硬膜外麻醉进行胸部手术,能降低麻药对循环及呼吸的抑制,缩短患者清醒时间,提高手术效果,值得临床推广应用。     

骶管阻滞用于小儿腹腔镜手术的临床研究

目的 :研究骶管阻滞用于小儿腹腔镜手术的麻醉效果及对呼吸循环的影响。方法 :选择 6岁以下ASAⅠ～Ⅱ级 38例患者于腹腔镜下行阑尾切除术、斜疝疝囊腹壁内环口高位结扎术 ,采用氯胺酮基础麻醉下行单次骶管阻滞 ,注入 0 6 %～ 1 0 %利多卡因 1 0～ 1 5ml kg。术中酌情辅助安定和 或芬氟合剂 ,观察麻醉效果 ,对照观察麻醉及气腹前后呼吸循环功能的改变。结果 :患者均镇痛充分 ,术中腹壁肌松良好 32例(84 2 % ) ,气腹后 1 0min潮气量显著下降 ,呼吸频率显著增加 (P <0 .0 1 ) ,而每分钟通气量及SpO2 无显著改变 ;气腹后 30min ,由于机体代偿性自身调节作用 ,呼吸功能显著改善。术中平均动脉压 (MAP)及心率 (HR)无显著变化 ,部分病例在骶管阻滞、气腹、辅助用药时血压下降明显 ,加快补液或静注麻黄碱后保持了循环稳定。结论 :0 6 %～ 1 0 %利多卡因 1 0～ 1 5ml kg单次骶管阻滞用于小儿腹腔镜手术麻醉 ,效果确切 ,可满足腹腔镜手术的需要     

腹腔镜胆囊切除术与腹腔镜妇科手术中麻醉、体位、CO2气腹对血流动力学及呼吸动力学影响的比较研究

目的:观察腹腔镜胆囊切除术(LC)与腹腔镜妇科手术中麻醉、体位、CO2气腹对血压、心率、SpO2、PetCO2、气道压的影响。方法:选择ASAⅠ~Ⅱ级择期行腹腔镜胆囊切除术,腹腔镜妇科手术病人各38例,予以异丙酚、异氟醚维持麻醉,分别于诱导前、插管后即刻、插管后5min、气腹后3min、8min及气腹放气后平卧位记录血流动力学及呼吸动力学参数。结果:两组插管后5min血压、心率明显低于诱导前;气腹后3min、8min血压、PetCO2、气道压明显高于插管后5min(P<0.01)。两组之间相比,妇科手术气道压、PetCO2显著高于LC组(P<0.01)。结论:腹腔镜妇科手术呼吸动力学的改变明显大于LC组,血流动力学改变两组间无显著差异。     

Clamping ischemia, threshold ischemia and delayed insertion of the shunt during carotid endarterectomy with patch.

BACKGROUND: Shunt insertion during carotid endarterectomy (CEA) is mandatory to avoid neurological damage due to clamping ischemia; however shunt insertion before plaque removal has many inconveniences (atheroembolism, intimal dissection, difficulty of endarterectomy). The aim of this study is to verify whether and how long shunt insertion may be safely delayed to permit plaque removal and ensure cerebral perfusion during the further time consuming manoeuvres of CEA (peeling, patch angioplasty). METHODS: From July 1990 to February 1996 383 patients underwent 411 CEAs under general anesthesia with EEG continuous monitoring and PTFE patch angioplasty. A Pruitt-Inahara shunt was routinely inserted only after atherosclerotic plaque removal. In 316 CEAs (76.9%) without EEG signs of cerebral ischemia (Group A) the mean clamping time was 10 min +/-4.8 (range 2-37 min). In 95 CEAs (23.1%) with EEG signs of cerebral ischemia (Group B) it was 7.3 min +/-3.5 (range 3-20 min). All patients had normal EEG signals after delayed shunt insertion and reperfusion (mean 21 min, range 5-45 min). RESULTS: In the short term results (within 30 days) there was a relevant neurological complication rate of 0.96% (2 major stroke and 2 lethal stroke); at awakening we observed 5 RINDs (1.21% of total) 1 in a patient of Group A (0.31%) and the other 4 in patients of Group B (4.21%). CONCLUSIONS: These data confirm the rationale of a delayed insertion of the shunt: actually the cerebral parenchyma may tolerate under general anesthesia a sufferance due to carotid clamping, EEG detectable, without neurological deficits for at least 7.3 min. This time is sufficient to perform the most difficult steps of CEA (plaque removal, distal intima checking) allowing shunt insertion in a clean operatory field, without inconveniences. Finally the shunt allows complementary time consuming steps, as patch angioplasty, with improvement of both short- and long-term results.     

腹腔镜胆囊切除术在急性胆囊炎中的应用

目的:探讨急性胆囊炎腹腔镜胆囊切除术的应用价值.方法:回顾分析2007年10月至2008年10月为18例急性胆囊炎患者行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的临床资料.均于发病72 h内施术,均发热,超过38.0C,无黄疸、上腹部手术史.经积极术前准备后均于3h内行LC.结...     

收肌管阻滞与股神经阻滞在患儿胫骨骨折闭合复位术中的比较

目的 比较收肌管阻滞和股神经阻滞在患儿胫骨骨折闭合复位术中的麻醉效果.方法 择期于全麻下行胫骨骨折闭合复位的患儿60例,男34例,女26例,ASAⅠ或Ⅱ级.采用随机数字表法分为三组:对照组(C组)、股神经阻滞组(F组)和收肌管阻滞组(A组),每组20例.C组采用单纯全麻,F组和A组在全麻后分别行股神经阻滞和收肌管阻滞(...     

Laparoscopic cholecystectomy under spinal anesthesia

BACKGROUND: Advantages of laparoscopic cholecystectomy (LC) such as less pain and short hospital stay make it the treatment of choice for cholelithiasis. There are limited data about LC under spinal anesthesia. This study was designed to evaluate LC under spinal anesthesia. METHODS: Twenty-nine patients underwent surgery for LC under spinal anesthesia at the 4th Department of Surgery of the Ankara Numune Education and Research Hospital between April 2005 and January 2006. All patients were informed about spinal anesthesia in detail. The patients also were informed about the risk of conversion to general anesthesia, and all patients provided informed consent. The election criteria for spinal anesthesia were as follows: American Society of Anesthesiologists (ASA) risk group 1 or 2; risk score for conversion from LC to open cholecystectomy (RSCO) less than negative 3; and presence of gallstone disease. Standard laparoscopic technique was applied to all patients. Simple questionnaire forms were developed for both patients and surgeons to provide comments about the operation. RESULTS: The operation was completed laparoscopically on 26 patients, while 3 patients needed general anesthesia due to severe right shoulder pain. None of the patients had cardiopulmonary problems other than transient hypotension during surgery. Intravenous fentanyl (25 microg) was needed in 13 patients due to severe right shoulder pain. Five patients still had severe shoulder pain after fentanyl injection. Local washing of the right diaphragm with 2% lidocaine solution was successful in the remaining 5 patients in whom fentanyl injection failed to stop the pain. All of the patients' answers to the questions regarding the comfort of operation were "very well" at the 1-month postoperative evaluation. All surgeons stated that there was no difference from LC under general anesthesia. CONCLUSIONS: All of the patients and surgeons were satisfied with LC under spinal anesthesia. Therefore, LC under spinal anesthesia may be an appropriate treatment choice to increase the number of patients eligible for outpatient surgery.     

艾司洛尔对腹腔镜胆囊切除术血流动力学及内分泌的影响

目的:探讨艾司洛尔对腹腔镜手术患者手术期间血流动力学及内分泌的影响。方法:30例全麻下腹腔镜手术患者被随机分为对照组(A组,n=15)和艾司洛尔组(B组,n=15),B组于诱导时经静脉推注艾司洛尔0.5mg/kg,气腹前给予艾司洛尔0.5mg/kg,然后以50μg/kg.m in-1速度持续输注。记录A组与B组患者气腹前(T1)、气腹10m in(T2)、20m in(T3)及放气后10m in(T4)、拔管后(T5)的心率(heart rate,HR)、收缩压(systolic b lood pressure,SBP)、舒张压(d iastolic b lood pressure,DBP)、平均动脉压(m ean arterial pressure,MAP)的改变,同时测定T1~T5血中儿茶酚胺和多巴胺的浓度。结果:A组气腹期间相应时点的SBP、DBP、MAP比T1明显升高(P<0.01);T3时A组儿茶酚胺、多巴胺比T1明显增高(P<0.01),B组上述指标相应时点与T1相比无明显改变。结论:艾司洛尔能很好地稳定气腹引起的血流动力学及内分泌的变化,维持内环境稳定,同时可减少吸入异氟醚最低肺泡有效浓度,缩短拔管时间。     

三种麻醉方法对腹腔镜手术二氧化碳气腹期间自主神经活动趋势的影响

目的以心率变异性（heart rate variability，HRV）为观察指标，观察分析不同的麻醉方法对腹腔镜胆囊切除手术（Laparoscopic cholecystectomy，LC）二氧化碳（CO2）气腹期间自主神经活动趋势的影响。方法选择ASAⅠ～Ⅱ级的择期L患者45例，按手术日期分为全身麻醉组（Ⅰ组，对照组）、全身麻醉＋艾司洛尔组（Ⅱ组）和全麻复合硬膜外阻滞组（Ⅲ组），分别在麻醉前，气腹前，气腹后5、10、20及30min观察HRV及血流动力学的变化。结果与气腹前相比，Ⅰ组低频（LF）、低频／高频（LF／HF）在气腹后不同时点均显著升高（P〈0．05）；Ⅱ组LF／HF在气腹后5、10min显著升高（P〈0．05）；Ⅲ组气腹后各时点LF、HF、LF／HF均无显著变化（P〉0．05）。组间比较，Ⅰ组LF、LF／HF在气腹后各时点均显著高于Ⅱ、Ⅲ组（P〈0．05），Ⅱ组LF在气腹后10min显著高于Ⅲ组（P〈0．05），LF／HF在气腹后5、10min显著高于Ⅲ组（P〈0．05）。HF各组间差异无显著性（P〉0．05）。结论艾司洛尔可减轻气腹引起的应激反应，但不能完全阻止其交感活性的增强；全麻复合硬膜外阻滞用于腹腔镜胆囊切除手术，可以抑制气腹引起的交感神经兴奋，维持自主神经的稳定性。     

Intravenous anesthesia with propofol in intracranial surgery]

OBJECTIVES: To analyze the repercussions of intravenous anesthesia with propofol as the single hypnotic drug on intracranial pressure (ICP) and cerebral perfusion pressure (CPP), and also to study the time until recovery from anesthesia and to tracheal extubation as well as intraoperative hemodynamic changes in patients undergoing surgery to remove a supratentorial brain tumor. PATIENTS AND METHODS: Twenty-three ASA I/II patients scheduled for exeresis of a supratentorial brain tumor were studied. A fiberoptic sensor placed in direct contact with the dura mater was used to measure ICP. Anesthetic induction was achieved with propofol (2 mg/kg). Propofol (12 and 9 mg/kg/h for 10 min and 6 mg/kg/h throughout the rest of the operation) was used for maintenance. Mean arterial pressure (MAP), heart rate (HR), ICP and CPP were recorded at baseline and 1, 2, 3 and 4 min after induction, during laryngoscopy and tracheal intubation; 1, 3, 5, 10, 15 and 20 min after tracheal intubation (L + 1, L + 3, L + 5, L + 10, L + 15, L + 20), upon placement of a craniostat; upon skin incision; upon withdrawal of propofol perfusion; and during extubation. The following variables were recorded after awakening: time until eye opening after receiving a verbal command, time until extubation and time until orientation. Analysis of variance for repeated measures (ANOVA) was performed on the results. RESULTS: MAP decreased significantly from baseline at the following times: during the post-induction period, upon placement of the craniostat, upon skin incision and when the propofol infusion was switched off. HR increased significantly during laryngoscopy and at the following moments: intubation, post intubation (L + 1, L + 3, L + 5), craniostat placement, and extubation. ICP was lower throughout the surgical period except during laryngoscopy, when this variable increased significantly. CPP decreased significantly after induction and returned to baseline after intubation. CPP was significantly higher after surgery. Recovery times after weaning from propofol infusion until eye opening in response to an order and until orientation were 13 +/- 3 and 22 +/- 4 min, respectively. The mean interval between withdrawal of propofol until extubation was 18 min. CONCLUSIONS: Intravenous anesthesia with propofol in intracranial surgery (supratentorial tumors) affords hemodynamic stability and lowers ICP except during laryngoscopy. Early recovery from anesthesia allows for neurological assessment and vigilance during the immediate postoperative period.     

内镜鼻胆管引流在腹腔镜胆囊切除术术后迟发性胆漏中的诊疗价值

目的:探讨内镜鼻胆管引流(endoscopic nasobiliary drainage,ENBD)诊断、治疗腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)术后迟发性胆漏的临床价值。方法:回顾分析1998年3月至2008年12月我院16例患者LC术后发生胆漏行ENBD的临床资料。结果:16例胆漏患者中5例胆囊管残端胆漏,10例迷走胆管漏,1例肝总管漏,均放置鼻胆管引流,2～3周后造影检查未见造影剂外溢,夹管观察无不适症状,拔鼻胆管,全部治愈出院。结论:ENBD对LC术后迟发性胆漏的诊断、治疗有很好的效果。     

应用响应曲面研究丙泊酚与瑞芬太尼在腹腔镜胆囊切除术麻醉中最佳配伍剂量

目的应用响应曲面分析法,观察丙泊酚与瑞芬太尼在镇静作用上的药效学相互作用规律,探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)靶控输注丙泊酚与瑞芬太尼的最佳配伍剂量。方法选择2014~2016年北京大学第三医院择期LC 100例,5例因手术方式改变、1例因术中出现过敏性休克退出研究,94例完成临床观察和随访。选择丙泊酚与瑞芬太尼靶控输注起始配伍浓度,观察靶控输注至警醒/镇静(Observer’s Assessment of Alertness/Sedation,OAA/S)评分≤1分的意识消失时间(time to loss of consciousenss,T LOC),术中根据脑电双频谱指数(bispectral index,BIS)、有创动脉血压和心率(heart rate,HR)调整丙泊酚和瑞芬太尼的靶控输注浓度,维持BIS 40~60、平均动脉压≥60 mm Hg、HR≥50次/min且平均动脉压和HR波动不超过基础值30%。记录停止输注瑞芬太尼与丙泊酚至OAA/S评分≥3分的意识恢复时间(time to recovery of consciousness,T ROC)。以受试者T LOC≤5 min、T ROC≤10 min、术中95%患者药效指标满意为目标,计算丙泊酚与瑞芬太尼在LC术中靶控浓度的最佳配伍范围。结果丙泊酚(2~9μg/ml)与瑞芬太尼(1~10 ng/ml)在T LOC和T ROC的药效上呈协同作用。LC药物靶控浓度的最佳配伍范围:丙泊酚2μg/ml(推荐监测BIS)伍用瑞芬太尼6~10 ng/ml,丙泊酚3μg/ml伍用瑞芬太尼3~5 ng/ml,丙泊酚4μg/ml伍用瑞芬太尼3 ng/ml,丙泊酚4.5μg/ml伍用瑞芬太尼2.6 ng/ml。丙泊酚浓度≥5μg/ml复合小剂量瑞芬太尼,45例中43例BIS<40;靶控输注丙泊酚2μg/ml复合瑞芬太尼6~10 ng/ml,给予气管插管刺激时,25例中2例BIS值呈一过性上升,术中BIS均维持在40~60。3例(3.2%)意识消失前出现呼吸暂停;7例(7.4%)麻醉诱导期间出现循环抑制,其中4例使用血管活性药物;21例(22.3%)主诉注射痛;7例(7.4%)出现多语和不自主活动。术后随访无知晓发生。结论丙泊酚(2~9μg/ml)与瑞芬太尼(1~10 ng/ml)在镇静药效反应呈协同作用;不同的药效反应相结合创建出的丙泊酚与瑞芬太尼最佳配伍剂量范围,可以为LC提供满意的麻醉,并且麻醉诱导和麻醉恢复快速。     

丙泊酚复合瑞芬太尼靶控输注在腹腔镜胆囊切除术中的应用

目的:观察丙泊酚复合瑞芬太尼靶控输注全凭静脉麻醉对腹腔镜胆囊切除术血流动力学及术后苏醒时间的影响。方法:50例择期行腹腔镜胆囊切除术的患者均采用丙泊酚复合瑞芬太尼靶控输注全凭静脉麻醉。设定诱导时静注咪达唑仑2mg,先血浆靶控输注瑞芬太尼4ng/ml,1min后血浆靶控输注丙泊酚3μg/ml或3.5μg/ml,患者意识消失后静注维库溴铵0.1mg/kg,3min后气管内插管,插管后丙泊酚靶浓度调至2μg/ml,术中维持根据需要调整丙泊酚靶浓度,以0.2μg/ml递增或递减,瑞芬太尼维持不变。记录诱导前、诱导后2min、插管即刻、插管后5min、气腹时、气腹后5min的收缩压(systolic bloodpressure,SBP)、舒张压(diastolic blood pressure,DBP)、心率(heart rate,HR)及术后呼吸恢复时间、呼之睁眼时间。结果:诱导后2min的SBP、DBP、HR与诱导前差异均有统计学意义(P0.05),气腹时SBP、DBP、HR有所升高,但差异无统计学意义,其他时点经适当调整丙泊酚靶浓度处理后逐渐平稳,术后呼吸恢复时间为(6.5±2.2)min,呼之睁眼时间(8.9±3.1)min。结论:丙泊酚复合瑞芬太尼靶控输注用于腹腔镜胆囊切除术安全,术中血流动力学平稳,术后苏醒快。