| 李珊珊,范 甜,黄一丹,秦文沛,王 江.瑞芬太尼复合丙泊酚麻醉对结肠癌手术患者血流动力学、炎症反应及免疫球蛋白的影响[J].,2020,(6):1111-1115 |
| 瑞芬太尼复合丙泊酚麻醉对结肠癌手术患者血流动力学、炎症反应及免疫球蛋白的影响 |
| Effects of Remifentanil Combined with Propofol Anesthesia on Hemodynamics, Inflammatory Response and Immunoglobulin in Patients Undergoing Colon Cancer Surgery |
| 投稿时间：2019-05-27 修订日期：2019-06-23 |
| DOI：10.13241/j.cnki.pmb.2020.06.025 |
| 中文关键词: 瑞芬太尼 丙泊酚 结肠癌 血流动力学 炎症反应 免疫球蛋白 |
| 英文关键词: Remifentanil Propofol Colon cancer Hemodynamics Inflammatory response Immunoglobulin |
| 基金项目:新疆维吾尔自治区自然科学基金项目（2016211B164） |
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| 中文摘要: |
| 摘要 目的：探讨瑞芬太尼复合丙泊酚麻醉对结肠癌手术患者血流动力学、炎症反应及免疫球蛋白的影响。方法：选取2017年1月~2018年12月期间于新疆医科大学附属第一医院行腹腔镜下结肠癌根治术患者189例，根据随机数字表法将患者分成对照组（n=94，丙泊酚麻醉）和研究组（n=95，瑞芬太尼复合丙泊酚麻醉），比较两组患者围术期指标、血流动力学、炎症反应及免疫球蛋白水平，记录两组术中不良反应发生情况。结果：研究组患者苏醒时间、拔管时间、自主呼吸恢复时间、定向力恢复时间均短于对照组（P<0.05）。对照组麻醉诱导10 min（T2）、术毕拔管后10 min（T3）时间点心率（HR）、平均动脉压（MAP）较T1时间点降低，T3时间点高于T2时间点（P<0.05），研究组T2时间点HR、MAP较T1时间点降低（P<0.05）；研究组T2、T3时间点HR、MAP高于对照组同时间点（P<0.05）。研究组术后1h（T4）、术后1d（T5）时间点白介素-6（IL-6）、C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）低于对照组同时间点（P<0.05）。研究组T4、T5时间点免疫球蛋白A（IgA）、免疫球蛋白M（IgM）、免疫球蛋白G（IgG）高于对照组同时间点（P<0.05）。两组不良反应发生率比较差异无统计学意义（P>0.05）。结论：结肠癌手术中使用瑞芬太尼复合丙泊酚麻醉，可有效改善围术期各项指标，维持机体血流动力学稳定，减少机体炎症反应、免疫抑制，安全可靠。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of remifentanil combined with propofol anesthesia on hemodynamics, inflammatory response and immunoglobulin in patients undergoing colon cancer surgery. Methods: 189 patients undergoing laparoscopic radical resection of colon cancer in the First Affiliated Hospital of Xinjiang Medical University from January 2017 to December 2018 were selected, they were divided into control group (n=94, propofol anesthesia) and study group (n=95, remifentanil combined with propofol anesthesia) according to random number table method. The perioperative indexes, hemodynamics, inflammatory reaction and immunoglobulin were compared between the two groups. The occurrence of intraoperative adverse reactions in the two groups was recorded. Results: The recovery time, extubation time, spontaneous breathing recovery time and orientation recovery time of the study group were shorter than those of the control group (P<0.05). The heart rate (HR) and mean arterial pressure (MAP) in the control group at 10 minutes after anesthesia induction (T2) and 10 minutes after extubation (T3) were lower than those at T1, those at T3 were higher than those at T2 (P<0.05). HR and MAP in the study group at T2 were lower than those at T1(P<0.05). HR and MAP in the study group at T2 and T3 were higher than those in the control group at the same time (P<0.05). The levels of interleukin-6 (IL-6), C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) in the study group at time points of 1h (T4) and 1d (T5) were lower than those in the control group at the same time point (P<0.05). Immunoglobulin A (IgA), M (IgM) and G (IgG) in the study group at T4 and T5 were higher than those in the control group at the same time point (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Remifentanil combined with propofol anesthesia in colon cancer surgery can effectively improve perioperative indicators, maintain hemodynamic stability, reduce inflammatory reaction and immunosuppression, and it is safe and reliable. |
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