乌拉地尔加芬太尼对CO2气腹下腹腔镜手术血流动力学的临床观察

目的：观察全麻期间应用芬太尼与乌拉地尔对CO2气腹建立时血流动力学的影响。方法：将104例病人随机分为4组,I组为对照组,Ⅱ组为芬太尼组,Ⅲ组为乌拉地尔组,Ⅳ组为乌拉地尔加芬太尼组。观察气腹前2min（T1）,气腹后1分钟（T2）、3min后（T3）、5min后（T4）、10min后（T5）4组病人的收缩压（SP）、舒张压（DP）、心率（HR）变化。结果：4组病人充气前各指标差异无显著性（P〈0.05）,I组病人充气后各时相的SP、DP、HR均高于充气前,差异有显著性（P〈0.05）;与Ⅰ组相比较Ⅱ组病人充气后HR显著下降（P〈0.05）;Ⅲ组病人充气后SP、DP显著下降,（〈0.05）;Ⅳ组病人充气后HR、SP、DP均显著下降（P〈0.05）。结论：乌拉地尔加芬太尼可明显减轻气腹时的应激反应,使血压、心率均明显降低,能有效地维持手术期间血流动力学稳定。

Observation of effect of urapidil and fentanyl on hemodynamics during pneumoperitoneum with carbon dioxide in laparoscope cholecystectomy

Objective：To observe the effect of urapidil combined with fentanyl on hemodynamics during pneumoperitoneum with carbon dioxide.Methods： 104 patients were randomly divided into four groups,group Ⅰ （control group）,group Ⅱ（ fentanyl）,groupm （ura- pidil） and group Ⅳ（urapidil with fentanyl）.To observe the deta of SP,DP,HR in four groups,at 2 rain before perflation（T1）, 1 min （T2）,3 rain （T3）,5 min（T4）, 10 rain after pertladon（TS）.Results：The data of SP, DP, HR significantly higher than that before pneumoperitoneum in group Ⅰ at each time（P〈0.05）;compared with group I HR decreased significantly in groupⅡ（P〈0.05）, SP, DP decreased significantly in group Ⅲ （P〈0.05）;HR, SP, DP decreased significantly in group Ⅳafter perflation（P〈0.05）.Conclusion： Fentanyl with urapidil can significantly reduce the stress response during pneumoperitoneum,decrease blood pressure and heart rate significantly to maintain hemodynamie stability effectively during surgery.