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目的探讨静脉与七氟谜吸入麻醉对腹腔镜下子宫肌瘤剥除术出血量的影响。方法将2014年10月至2016年10月行腹腔镜下子宫肌瘤剥除术的240例子宫肌瘤患者按照奇偶数字法分为对照组与观察组,每组120例。对照组采用七氟醚吸入麻醉,观察组采用全凭静脉麻醉。对比麻醉诱导前(T0)、气腹后0.5 h(T1)、手术结束时(T2)以及拔出气管导管之后3 min时(T3)的收缩压(SBP)、舒张压(DBP)以及心率(HR),对比分析两组术中出血量、手术时间、术后肠道恢复时间以及住院时间。结果对照组在麻醉过程中血流动力学指标水平变化不稳定,其中T1及T3时SBP、DBP及HR水平显著高于本组其他时点与观察组对应时点(P<0.05);观察组手术时间显著长于对照组(P<0.05),其他指标(术中出血量、术后肠道恢复时间、住院时间)水平均显著小于对照组(P<0.05)。结论与七氟醚吸入麻醉相比,全凭静脉麻醉对腹腔镜下子宫肌瘤剥除术的影响较小,且患者出血量较少,应在临床中进行推广。
Objective To investigate the effect of intravenous and sevoflurane inhalation anesthesia on the amount of bleeding after laparoscopic hysterectomy. Methods From March 2014 to October 2016, 240 patients with uterine leiomyoma who underwent laparoscopic hysterectomy were divided into control group and observation group according to the odd-even number method, with 120 cases in each group. The control group was inhaled anesthesia with sevoflurane, and the observation group received total intravenous anesthesia. The changes of SBP, DBP and heart rate before anesthesia induction (T0), 0.5 h after pneumoperitoneum (T1), at the end of surgery (T2) and 3 min after tracheal extubation (T3) HR), comparative analysis of two groups of intraoperative blood loss, operation time, postoperative intestinal recovery time and hospitalization time. Results The level of hemodynamics in the control group changed unstably during the anesthesia. The levels of SBP, DBP and HR at T1 and T3 were significantly higher than those at the other time points in the control group (P <0.05). The observation group The operation time was significantly longer than that of the control group (P <0.05). The other indexes (intraoperative blood loss, postoperative intestinal recovery time, hospital stay) were significantly lower than those of the control group (P <0.05). Conclusion Compared with inhalation anesthesia with sevoflurane, total intravenous anesthesia has little effect on laparoscopic myomectomy, and patients with less bleeding, should be promoted in the clinic.