舒芬太尼对腹腔镜胆囊切除术患者血流动力学、氧化应激及血管内皮功能的影响

摘要

目的:探讨舒芬太尼对腹腔镜胆囊切除术患者血流动力学、氧化应激及血管内皮功能的影响.方法:88例行腹腔镜胆囊切除术患者作为研究对象,依据随机数据表法分为对照组(n =44)和观察组(n=44),对照组患者给予芬太尼麻醉,观察组给予舒芬太尼麻醉,比较两组患者在麻醉诱导前(T0),气腹形成时(T1)及手术结束时(T2)三个时刻的血流动力学、氧化应激及血管内皮功能指标水平.结果:两组T0时刻HR、SBP、DBP、CAT、SOD、MDA、NO和ET-1水平比较差异无统计学意义(P＞0.05);与T0时刻水平相比,两组T1、T2时刻HR、SBP、DBP、MDA水平均不同程度的升高,且观察组T1、T2时刻水平显著低于对照组,差异有统计学意义(P＜0.05);两组T1、T2时刻CAT、SOD水平均不同程度的低于T0时刻,且观察组两时刻水平均显著高于对照组(P＜0.05);两组T1时刻NO和ET-1水平均显著升高,且观察组NO水平显著高于对照组,ET-1水平显著低于对照组(P＜0.05),T2时刻NO和ET-1水平比较,差异不显著(P＞0.05).结论:与芬太尼相比,舒芬太尼对腹腔镜胆囊切除术患者血流动力学影响更小,可有效减轻机体氧化应激损伤,保护血管内皮功能,更有利于恢复.%Objective:To investigate the effect of sufentanil on hemodynamics,oxidative stress and vascular endothelial function in patients undergoing laparoscopic cholecystectomy.Methods:A total of 88 patients undergoing laparoscopic cholecystectomy were divided into control group (n =44) and observation group (n =44) according to random data table,the patients in the control group received fentanyl anesthesia,and the observation group patients were given sufentanil anesthesia,the levels of hemodynamic,oxidative stress and vascular endothelial function at three times before anesthesia induction (T0),pneumoperitoneum (T1) and at the end of surgery (T2) between the two groups were compared.Results:At T0 moment,the levels of T0,SBP,HR,DBP,CAT,SOD,NO,MDA and ET-1 in the two groups were not statistically significant (P ＞0.05);Compared with the level of T0 moment,the levels of HR,SBP,DBP,and MDA in the two groups at T1 and T2 moment were increased in different degrees,and the levels of T1 and T2 in the observation group were significantly lower than those in the control group (P＜0.05);The levels of CAT and SOD in the two groups of T1 and T2 moment were lower than T0 moments in different degrees,and the observation group at two time levels were significantly higher than the control group (P＜0.05);The levels of NO and ET-1 in the two groups of T1 moment were significantly increased,and in the observation group the level of NO was significantly higher and ET-1 was significantly lower than that in the control group,all differences were statistically significant (P＜0.05);There was no significant difference of the NO and ET-1 levels at T2 between the two groups (P＞0.05).Conclusion:Compared with fentanyl,sufentanil has less influence on hemodynamics in laparoscopic cholecystectomy.It can effectively reduce oxidative stress and protect vascular endothelial function,and is more conducive to recovery.