不同配比依托咪酯与丙泊酚混合液在宫腔镜手术中的麻醉效果分析.docx

    不同配比依托咪酯与丙泊酚混合液在宫腔镜手术中的麻醉效果分析    王利玉【Summary】 目的：分析不同配比依托咪酯與丙泊酚混合液在宫腔镜手术中的麻醉效果方法：选取2019年1月-2020年1月本院收治的186例行宫腔镜手术患者为研究对象依据麻醉时所用依托咪酯与丙泊酚混合液配比的不同分为低配比组、中配比组和高配比组，各62例首先静脉输注50 μg枸橼酸芬太尼注射液，3 min未发现不良反应，输注依托咪酯注射液与丙泊酚注射液混合液低配比组所用依托咪酯与丙泊酚混合液配比为10 mg∶100 mg，中配比组所用依托咪酯与丙泊酚混合液配比为20 mg∶100 mg，高配比组所用依托咪酯与丙泊酚混合液配比为40 mg∶100 mg比较三组患者的麻醉效果、血流动力学变化情况、不良反应发生情况结果：高配比组依托咪酯用量明显高于低配比组和中配比组，且中配比组明显高于低配比组，差异均有统计学意义（P<0.05）;高配比组丙泊酚用量明显低于低配比组和中配比组，且中配比组明显低于低配比组，差异均有统计学意义（P<0.05）高配比组和中配比组的术中诱导时间均明显短于低配比组，差异均有统计学意义（P<0.05）;高配比组和中配比组的术中诱导时间比较，差异无统计学意义（P>0.05）。

低配比组和中配比组的术后复苏时间、定向力恢复时间均明显短于高配比组，差异均有统计学意义（P<0.05）;低配比组和中配比组的术后复苏时间、定向力恢复时间比较，差异均无统计学意义（P>0.05）术中15 min和术后10 min，低配比组和中配比组HR、SpO、MAP比较，差异均无统计学意义（P>0.05）;高配比组HR、SpO、MAP均明显低于低配比组和中配比组，差异均有统计学意义（P<0.05）高配比组的不良反应发生率为19.35%，明显高于低配比组的3.23%和中配比组的4.84%，差异均有统计学意义（P<0.05）; 低配比组和中配比组的不良反应发生率比较，差异无统计学意义（P>0.05）结论：在宫腔镜手术中应用依托咪酯与丙泊酚混合液配比为20 mg∶100 mg进行麻醉效果显著，患者血流动力学稳定，且安全性较高，值得广泛推广Key】 依托咪酯 丙泊酚 宫腔镜手术 麻醉效果 血流动力学Analysis of Anesthetic Effect of Different Ratio of Etomidate and Propofol Mixture in Hysteroscopic Surgery/WANG Liyu. //Medical Innovation of China， 2021， 18（23）： 00-009[Abstract] Objective： To analyze the anesthetic effect of different ratio of Etomidate and Propofol mixture in hysteroscopic surgery. Method： A total of 186 patients undergoing hysteroscopic surgery in our hospital from January 2019 to January 2020 were selected as the research objects. According to the different ratio of Etomidate and Propofol mixture used in anesthesia， the patients were divided into low-ratio group， medium-ratio group and high-ratio group， 62 cases in each group. First， intravenous infusion 50 μg Fentanyl Citrate Injection， no adverse reaction was found within 3 min， and the mixture of Etomidate Injection and Propofol Injection was infused. The mixture ratio of Etomidate and Propofol in low-ratio group was 10 mg∶100 mg， the mixture ratio of Etomidate and Propofol was 20 mg∶100 mg in the medium-ratio group， the mixture ratio of Etomidate and Propofol in high-ratio group was40 mg∶100 mg. The anesthetic effect， hemodynamic changes and the occurrence of adverse reactions were compared among the three groups. Result： The dosage of Etomidate in the high-ratio group was significantly higher than those in the low-ratio group and the medium-ratio group， and the medium-ratio group was significantly higher than that in the low-ratio group， the differences were statistically significant （P<0.05）. The dosage of Propofol in the high-ratio group was significantly lower than those in the low-ratio group and the medium-ratio group， and the medium-ratio group was significantly lower than that in the low-ratio group， the differences were statistically significant （P<0.05）. The intraoperative induction time of the high-ratio group and medium-ratio group were significantly shorter than that of the low-ratio group， the differences were statistically significant （P<0.05）. Comparison of intraoperative induction time between the high-ratio group and the medium-ratio group， there was no significant difference （P>0.05）. The postoperative recovery time and directional force recovery time of the low-ratio group and the medium-ratio group were significantly shorter than that of the high-ratio group， the differences were statistically significant （P<0.05）. Comparison of postoperative recovery time and directional force recovery time between low-ratio group and medium-ratio group， there were no significant differences （P>0.05）. 15 min intraoperatively and 10 min postoperatively， comparison of HR， SpO2 and MAP between low-ratio group and medium-ratio group， there were no statistical significance （P>0.05）. HR， SpO2 and MAP in the high-ratio group were significantly lower than those in the low-ratio group and medium-ratio group， the differences were statistically significant （P<0.05）. The incidence of adverse reactions in the high-ratio group was 19.35%， which was significantly higher than 3.23% in the low-ratio group and 4.84% in the medium-ratio group， the differences were statistically significant （P<0.05）. Comparison of the incidence of adverse reactions between the low-ratio group and the medium-ratio group， there was no significant difference （P>0.05）. Conclusion： In hysteroscopic surgery， the mixture ratio of Etomidate and Propofol is 20 mg∶100 mg for anesthesia， which has significant effect， stable hemodynamics and high safety， and is worthy of widespread promotion.[Key words] Etomidate Propofol Hysteroscopic surgery Anesthetic effect HemodynamicsFirst-author’s address： The Third Affiliated Hospital of Sun Yat-Sen University Yuedong Hospital， Meizhou 514000， Chinadoi：10.3969/j.issn.1674-4985.2021.23.002随着微创技术的快速发展，宫腔镜手术因能够清晰地观察到宫腔内的各种改变，被广泛应用于治疗和诊断妇科疾病[1-2]。

然而宫腔镜手术在进行操作时，难免会对宫腔内部组织造成创伤性的损害，常用麻醉进行干预目前临床上常用依托咪酯、丙泊酚作为宫腔镜手术的麻醉药物，有研究报道，依托咪酯与丙泊酚混合液的麻醉效果明显优于单用依托咪酯、丙泊酚[3-4]然而，针对依托咪酯与丙泊酚不同比例混合后麻醉效果的研究较少且有研究报道，不同配比依托咪酯与丙泊酚混合液所起到的麻醉效果，安全性不同[5]鉴于此，本文为了分析不同配比依托咪酯与丙泊酚混合液在宫腔镜手术中的麻醉效果，。