目的 观察七氟醚对腹腔镜手术下血浆心钠素(ANP)及内皮素(ET)的影响.方法 择期腹腔镜胆囊切除手术患者40例,随机双盲均分为两组:研究组(S组),术中吸入七氟醚维持麻醉；对照组(P组),术中持续靶控输注丙泊酚.记录麻醉前(T0)、插管前(T1)、插管后(T2)、气腹即刻(T3)、气腹15 min(T4)、气腹结束(T5)、手术结束(T6)时的MAP、HR.检测T0、T3～T5时两组血浆ANP和ET的含量.结果 T3时P组的MAP明显高于T1、T2、T5时(P＜0.05)；T6时S组HR明显快于T3时(P＜0.05)；P组Ta～T5时ET、T5时ANP明显高于T0时和S组(P＜0.05).结论 七氟醚能够减轻气腹状态下ET分泌,稳定ANP,抑制应激反应,稳定血流动力学.%Objective To observe the effect of Sevoflurane on plasma atrial natnuretic peptide (ANP) and endothelin (ET) in patients undergoing laparoscopic surgery with carbon dioxide pneumoperitoneum. Methods Forty patients were randomly and double-blindly divided into two groups: observational group (group S) and control group(group P). Sevoflurane was used in group S and propofol was used in group P. MAP and HR were recorded before induction of anesthesia(T0), before intubation (T1), immediately after intubation (T2), at the beginning of pneumoperitoneum (T3), after 15 minutes of pneumoperitoneum(T4) , at the end of pneumoperitoneum (T5) and at the end of operation(T6). Plasma ANP and ET were measured at T0 ,T3-T5. Results MAP at T3 was higher than that at T1 ,T2 ,Ts in group P(P<0. 05). HR at T6 was higher than that at T3 in group S (P<0. 05). Plasma ET at T3-T5 in group P was higher than that at T0 in group S(P<0. 05) , ANP in group P was higher at T5 than that at T0 in group S. Conclusion Sevoflurane can stabilize the hemodynamic and inhibit the stress response by reducing the secretion of ET and ANP.
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