不同麻醉药物对老年腹腔镜胆囊切除术患者应激反应的影响

目的 探讨老年腹腔镜胆囊切除术患者使用不同麻醉药物的应激反应情况.方法 选择老年腹腔镜胆囊切除术患者90例为研究对象,随机分为三组.第1组采用丙泊酚联合芬太尼诱导麻醉后采用异氟烷维持麻醉;第2组采用丙泊酚联合瑞芬太尼诱导后持续维持;第3组采用丙泊酚联合瑞芬太尼诱导后采用丙泊酚联合七氟烷维持麻醉.比较三组术中情况以及应激反应情况.结果 第2组在切皮前、胆囊切除时、拔管后30 min的收缩压、舒张压、平均动脉压、血清皮质醇、血糖、IL-6、CRP均显著低于第1组和第3组（P均＜0.01）.结论 三种麻醉方法患者均有不同程度的应激反应,但丙泊酚联合瑞芬太尼维持麻醉能较好地控制患者的应激反应.

Effect of different anesthesia on stress reaction of elderly laparoscopic cholecystectomy

Objective To discuss effect of different anesthesia on stress reaction of elderly laparoscopic cholecystecto- my. Methods Selected 90 cases with laparoscopic cholecystectomy, were randomly divided into 3 groups. The first group was induced anesthesia by propofol combined with fentanyl, then continuous anesthesia with isoflurane. The second group was induced anesthesia by propofol combined with remifentanil, then continuous anesthesia. The third group was induced anesthesia by propofol combined with remifentanil, then continuous anesthesia with propofol com- bined with sevoflurane. Results SBP, DBP, MAP, Cor, Glu, IL-6, CRP of the second group were lower than the first group and the third group before skin incision, at gallbladder removal, 30rains after extubation （P all〈0.01）. Conclu- sion Patients with three anesthesia methods show different degrees of stress reaction; Propofol combined with remifen- tanil can control stress reaction better.