依托咪酯诱导与维持麻醉对肺癌根治术患者血清皮质醇含量的影响  

Effects of etomidate infusion on serum cortisol in patients undergoing radical resection of lung cancer

作　　者：谢咏秋[1] 焦赫娜[1] 郭曲练[1] 陈婵[1] 

机构地区：[1]中南大学湘雅医院麻醉科,湖南长沙410008

出　　处：《南方医科大学学报》2010年第5期1047-1049,共3页Journal of Southern Medical University

基　　金：湖南省自然科学基金(06JJ4122)

摘　　要：目的观察依托咪酯复合麻醉对肺癌根治术患者血浆皮质醇含量的影响。方法选择40例20～60岁、ASAⅠ～Ⅱ级、择期第一台肺癌根治术患者随机分为两组:依托咪酯组(E组)在诱导和维持中选用依托咪酯,丙泊酚组(P组)在诱导和维持中选用丙泊酚,每组20例。采用放射免疫分析技术测定患者麻醉前(8Am)、术后当日4Pm和术后24h静脉血浆皮质醇含量。结果两组间比较,各时点皮质醇浓度无统计学差异。组内比较,术后当日皮质醇浓度均较术前稍有下降,但无统计学意义(P>0.05),并且高于正常值,术后24h时皮质醇浓度均较术前增高(P<0.01)。结论短时间对肾上腺皮质功能正常患者使用依托咪酯诱导与维持对肺癌根治术患者皮质醇合成和分泌无明显影响。Objective To evaluate the effect of etodimate infusion on serum cortisol in patients undergoing radical resection of lung cancer operations during the perioperative period. Methods Forty ASA I-II patients undergoing radical resection of lung cancer were randomly divided into etomidate group （Group E） and propofol group （Group P） （n=20）. The serum cortisol was measured at 8：00 am （T0） before anesthesia, 4：00 pm （T1） on the day of operation and 24 h after the operation （T2） by radioimmunoassay. Results Compared with that at T0, the serum level of cortisol significantly increased at 24 h after the operation in both groups （P0.01）; serum cortisol decreased lightly at T1, which was not statistically significant （P0.05）, and remained higher than the normal level. At each of the time points, serum cortisol levels were comparable between the two groups （P0.05）. Conclusion Etomidate infusion can not inhibit the synthesis of cortisol in patients undergoing radical resection of lung cancer.

关 键 词：依托咪酯 丙泊酚 麻醉 皮质醇 肺肿瘤/外科学 

分 类 号：R614.24[医药卫生—麻醉学] R655.3[医药卫生—外科学]