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丙泊酚靶控输注复合瑞芬太尼在腹腔镜直肠癌根治术中的麻醉效果观察 预览

Effect of propofol target-controlled infusion combined with remifentanil anesthesia on laparoscopic radical resection of rectal cancer
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摘要 目的探讨丙泊酚靶控输注(TCI)联合瑞芬太尼麻醉对直肠癌患者行腹腔镜直肠癌根治术中血流动力学及术后认知功能的影响。方法将2015年3月至2018年6月间肇庆市第一人民医院收治的40例拟行腹腔镜直肠癌根治术患者根据随机数表法分为观察组和对照组,每组20例。观察组应用丙泊酚靶控输注复合瑞芬太尼麻醉,对照组应用静吸复合麻醉。比较两组患者入室后15 min (T1)、诱导时刻(T2)、插管时刻(T3)、插管后1 min (T4)、切皮建立气腹时(T5)、切皮建立气腹后5 min (T6)、拔管时(T7) 7个时间点的收缩压(SBP)、舒张压(DBP)、心率(HR);比较两组患者的诱导时间、清醒时间、拔管时间及清醒情况。结果两组患者T1~T4时点的HR、SBP及DBP均呈下降趋势,T4~T7时点呈上升趋势,但观察组上述指标波动较小,对照组波动明显,组间比较,对照组T4、T5和T6时点HR、SBP及DBP均高于观察组,差异均有统计学意义(P<0.05);观察组和对照组患者的诱导时间分别为(3.0±1.1) min和(3.8±1.2) min、清醒时间分别为(8.8±2.8) min和(11.1±3.8) min、拔管时间分别为(12.4±3.2) min和(17.5±5.9) min,观察组均明显短于对照组,差异均有统计学意义(P<0.05);拔管后,观察组患者的认知功能障碍评估标准(MMSE)评分为(28.06±0.98)分,明显高于对照组的(25.97±1.04)分,差异有统计学意义(P<0.05)。结论丙泊酚联合瑞芬太尼麻醉对行腹腔镜直肠癌根治术患者术中血流动力学影响小,安全性高,可改善患者术后认知功能。 Objective To investigate the effect of propofol targeted-controlled infusion(TCI) combined with remifentanil anesthesia on the hemodynamics and postoperative cognitive function of rectal cancer patients undergoing laparoscopic radical resection. Methods From March 2015 to June 2018, 40 patients undergoing laparoscopic radical resection of rectal cancer in Zhaoqing First People’s Hospital were randomly divided into the observation group and the control group, with 20 patients in each group. The observation group used propofol TCI combined with remifentanil anesthesia, and the control group was treated with static inhalation combined anesthesia. The systolic blood pressure(SBP), diastolic blood pressure(DBP), heart rate(HR) at 15 min(T1), induction time(T2), intubation time(T3), 1 min after intubation(T4), time of establishing pneumoperitoneum(T5), 5 min after establishing pneumoperitoneum(T6), extubation time(T7) were compared between the two groups. The induction time, awakening time, extubation time, and awakening status of the two groups were compared. Results HR, SBP and DBP showed a downward trend in the two groups at T1, T2, T3, T4 and an upward trend at T4, T5, T7. The fluctuation of the above indexes in the observation group was small, and that in the control group was significant. The HR, SBP and DBP at T4, T5 and T6 in the control group were higher than those in the observation group, and the difference was statistically significant(P<0.05). The induction time, awaking time, extubation time of the observation group were(3.0±1.1) min,(8.8±2.8) min,(12.4±3.2) min,respectively, versus(3.8±1.2) min,(11.1±3.8) min,(17.5±5.9) min in the control group(P<0.05). After extubation, the mini-mental state examination(MMSE) score(cognitive impairment) of the observation group was significantly higher than that of the control group(P<0.05):(28.06±0.98) in the observation group versus(25.97±1.04) in the control group.Conclusion The effect of propofol TCI combined with remifentanil anesthesia on the postoperati
作者 梁健群 卢先卿 黄素娟 林海波 欧阳文博 曾海锋 LIANG Jian-qun;LU Xian-qing;HUANG Su-juan;LIN Hai-bo;OUYANG Wen-bo;ZENG Hai-feng(Zhaoqing First People’s Hospital,Zhaoqing 526100,Guangdong,CHINA)
出处 《海南医学》 CAS 2019年第3期307-309,共3页 Hainan Medical Journal
基金 广东省肇庆市科技创新计划项目(编号:2015040307).
关键词 腹腔镜直肠癌根治术 丙泊酚 瑞芬太尼 靶控输注 血流动力学 术后认知功能 Laparoscopic radical resection of rectal cancer Propofol Remifentanil Target-controlled infusion(TCI) Hemodynamics Postoperative cognitive function
作者简介 通讯作者:梁健群,E-mail:resecti5@126.com.
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