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目的:评价肌氧饱和度(SmOn 2)目标导向麻醉管理对腹腔镜子宫切除术患者组织灌注的影响。n 方法:择期拟行腹腔镜子宫切除术患者80例，年龄18～64岁，ASA分级Ⅰ或Ⅱ级。按信封法随机分为试验组(T组) 和对照组 (C组)，每组40例。常规静脉麻醉诱导后置入喉罩行机械通气，T组麻醉医师按照制订方案维持体侧肌氧饱和度(SfmOn 2)和前臂内侧肌氧饱和度(SamOn 2)均不低于70%和基线值；C组麻醉医师根据临床常规进行麻醉管理。于入室(Tn 0)、气腹前即刻(Tn 1)、气腹后40 min(Tn 2)和关闭气腹后10 min(Tn 3)时记录MAP、心脏指数(CI)、每搏输出量(SV)、体循环阻力(SVR)、SfmOn 2和SamOn 2。Tn 1-3时取中心静脉血行血气分析，记录pH值、PCOn 2、POn 2、乳酸浓度和碳酸氢根(HCOn 3-)浓度。术后24 h时记录15项量表评分(QoR-15评分)及恶心呕吐等的发生情况。n 结果:与C组比较，T组Tn 2，3时血乳酸浓度降低，Tn 1-3时SamOn 2、Tn 2，3时SfmOn 2和Tn 2时CI升高，SVR降低，术后24 h时QoR-15评分升高，恶心发生率降低(n P0.05)。n 结论:SmOn 2目标导向麻醉管理可改善腹腔镜子宫切除术患者组织灌注，提高术后恢复质量。n “,”Objective:To evaluate the effect of goal-directed anesthesia management based on muscle oxygen saturation (SmOn 2) on tissue perfusion in the patients undergoing laparoscopic hysterectomy.n Methods:Eighty patients, aged 18-64 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , scheduled for elective laparoscopic hysterectomy, were divided into test group (group T) and control group (group C) according to the envelope method, with 40 patients in each group.After patients entering the operating room, SmOn 2 was measured at flank (SfmOn 2) and on forearm(SamOn 2), and the baseline values were recorded.After conventional induction of intravenous anesthesia, a laryngeal mask was placed for mechanical ventilation.For patients in group T, the anesthesiologist maintained SfmOn 2 and SamOn 2 not less than 70% and not less than the baseline value according to the established intervention plan.For patients in group C, anesthesiologists performed anesthesia management according to clinical routines.Mean arterial pressure (MAP), cardiac index (CI), stroke volume (SV), systemic circulation resistance (SVR), SfmOn 2 and SamOn 2 were recorded on admission to the operating room (baseline value, Tn 0), immediately before pneumoperitoneum (Tn 1), at 40 min after pneumoperitoneum (Tn 2), and at 10 min after closing pneumoperitoneum (Tn 3). Central venous blood samples were collected at Tn 1-3 for blood gas analysis, and the pH value, PCOn 2, POn 2, lactic acid concentration and bicarbonate concentration (HCOn 3-) were recorded.The Quality of Recovery-15 (QoR-15) score and postoperative complications such as nausea and vomiting were recorded at 24 h after operation.n Results:Compared with group C, blood lactic acid concentrations were significantly decreased at Tn 2, 3, SamOn 2 at Tn 1-3, SfmOn 2 at Tn 2, 3 and CI at Tn 2 were increased, SVR was decreased, QoR-15 score was increased at 24 h after operation, and the incidence of nausea was decreased in group T (n P0.05).n Conclusion:Goal-directed anesthesia management based on SmOn 2 can improve tissue perfusion and the quality of postoperative recovery of the patients undergoing laparoscopic hysterectomy.n