目的探讨舒芬太尼静吸复合麻醉对腹腔镜卵巢囊肿剔除术患者血管内皮功能及氧化应激影响。方法选择2010年1月至2012年1月接受腹腔镜卵巢囊肿剔除术的良性卵巢囊肿患者76例，随机分为观察组（39例）及对照组（37例），评估舒芬太尼及芬太尼对2组患者血糖及内皮功能、血清氧化应激状态的影响。结果两组患者麻醉前及建立气腹前、解除气腹后30minNO、ET-1、血糖水平无显著性差异（P>0.05），建立气腹后30min两组NO较麻醉前有显著升高（P<0.05，P<0.01），观察组较对照组有显著性升高（P<0.05）。建立气腹后30min两组ET-1较麻醉前有显著升高（P<0.01，P<0.05），观察组较对照组有显著性下降（P<0.05）。建立气腹后30min对照组血糖较麻醉前有显著升高（P<0.05），观察组较对照组有显著性下降（P<0.05）。两组患者麻醉前及建立气腹前、解除气腹后30minCAT、SOD、GSH水平并无显著性差异（P>0.05），建立气腹后30min两组CAT较麻醉前有显著升高（P<0.01，P<0.05），观察组较对照组有显著性下降（P<0.05）。建立气腹后30min两组SOD较麻醉前有显著下降（P<0.05），观察组较对照组有显著性升高（P<0.05）。建立气腹后30min对照组GSH较麻醉前有显著下降（P<0.01，P<0.05），观察组较对照组有显著性升高（P<0.05）。NO与CAT呈显著负相关（P<0.05），NO与SOD、GSH呈显著正相关（P<0.05，P<0.01）。ET-1与CAT呈显著正相关（P<0.05），ET-1与SOD、GSH呈显著负正相关（P<0.05）。结论舒芬太尼静吸复合麻醉较芬太尼更好地维持气腹所致血管内皮功能紊乱并降低氧化损伤。%Objective To investigate vascular endothelial function and oxidative stress impact of sufentanil inhalation anesthesia for patients undergoing of laparoscopic ovarian cyst removed. 76 patients were selected durign the period from January 2010 to January 2012 in our hospital received laparoscopic ovarian cyst excision of benign ovarian cyst were randomly and divided into observation group(39 cases)and control group(37 cases),2 groups of patients with blood glucose and endothelial function, serum oxidative stress status were assessed. Results NO,ET-1,glucose levels between the two groups before anesthesia,before the establishment of pneumoperitoneum,lift pneumoperitoneum 30min showed no significant difference(P>0.05),the establishment of pneumoperitoneum significantly increased(P<0.05,P<0.01),the observation group significantly increased than the control group(P<0.05). 30min after establishing pneumoperitoneum in two groups of ET-1 than before anesthesia was significantly higher (P<0.01,P<0.05),the observation group than the control group significantly decreased(P<0.05). 30min after establishing pneumoperitoneum of control group blood sugar than before anesthesia was significantly higher(P<0.05),the observation group than the control group significantly decreased(P <0.05). The two groups of patients before anesthesia and before the establishment of pneumoperitoneum,lift pneumoperitoneum 30minCAT,SOD,GSH levels had no significant difference(P> 0.05),after establishing pneumoperitoneum 30min the CAT than before anesthesia significantly increased(P<0.01,P<0.05),the observation group than the control group significantly decreased(P<0.05). 30min two sets of SOD than before anesthesia after establishing pneumoperitoneum decreased significantly(P<0.05),and the observation group than in the control group significantly increased (P<0.05). After establishing pneumoperitoneum 30min control group GSH than before anesthesia decreased significantly(P<0.01, P<0.05),and the observation group than the control group significantly increased(P<0.05). NO and CAT showed a significant negative correlation(P<0.05),NO and SOD,GSH was significantly positively correlated(P<0.05,P<0.01). ET-1 and CAT had a significant positive correlation(P<0.05),ET-1 and SOD,GSH was significantly the negative positively correlated(P<0.05). Conclusion Sufentanil inhalation anesthesia than fentanyl can better maintain pneumoperitoneum induced endothelial dysfunction and reduce oxidative damage.
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