瑞芬太尼联合依托咪酯对无痛纤维支气管镜检查过程中全身应激反应的影响  

Effect of remifentanil combined with etomidate on systemic stress reaction during painless fiberoptic bronchoscopy

作　　者：谢东武[1] 

机构地区：[1]四川省绵阳市中心医院麻醉科,四川绵阳621000

出　　处：《海南医学院学报》2017年第8期1127-1130,共4页Journal of Hainan Medical University

基　　金：绵阳市卫生局科研基金资助项目(201119)~~

摘　　要：目的:研究瑞芬太尼联合依托咪酯对无痛纤维支气管镜检查过程中全身应激反应的影响。方法:选择于本院门诊及病房接受无痛纤维支气管镜检查的84例患者作为研究对象并随机分为两组,观察组患者接受瑞芬太尼联合依托咪酯麻醉方案、对照组接受表面麻醉方案,检查过程中检查各个时间段(检查前、检查中、检查后)分别采集血清并检测应激指标。结果:检查前,两组患者血清中NE、E、ACTH、Cor、PRA、AT-Ⅱ、ALD、CRP、TNF-α、IL-6、MCP-1的含量无显著性差异;检查中及检查后,两组患者血清中NE、E、ACTH、Cor、PRA、AT-Ⅱ、ALD、CRP、TNF-α、IL-6、MCP-1的含量均显著高于检查前且观察组患者血清中NE、E、ACTH、Cor、PRA、AT-Ⅱ、ALD、CRP、TNF-α、IL-6、MCP-1的含量均显著低于对照组。结论:瑞芬太尼联合依托咪酯能够显著抑制无痛纤维支气管镜检查过程中全身应激反应的激活以及应激激素的释放。Objective： To study the effect of remifentanil combined with etomidate on systemic stress reaction during painless fiberoptic bronchoscopy. Methods： A total of 84 patients who received painless fiberoptic bronchoscopy in outpatient and ward of our hospital between May 2014 and October 2016 were selected as the research subjects and randomly divided into two groups, observation group of patients accepted remifentanil combined with etomidate anesthesia, control group of patients received surface anesthesia, and in various time periods of inspection （before, during and after inspection）, serum was collected respectively to test stress indexes. Results： Before inspection, serum NE, E, ACTH, Cot, PEA, AT-II, ALD, CRP, TNF- α, IL-6 and MCP-1 contents were not significantly different between two groups of patients; during and after inspection, serum NE, E, ACTH, Cor, PRA, AT-II, ALD, CRP, TNF-α, IL-6 and MCP-1 contents of both groups of patients were signifi cantly higher than those before inspection, and serum NE, E, ACTH, Cot, PRA, AT-II, ALD, CRP, TNF-α, IL-6 and MCP-1 contents of observation group were significantly lower than those of control group. Conclusions： Remifentanil combined with etomidate can significantly inhibit the activation of systemic stress reaction and the release of stress hormones during painless fiberoptic bronchoscopy.

关 键 词：纤维支气管镜 瑞芬太尼 依托咪酯 应激反应 

分 类 号：R768.1[医药卫生—耳鼻咽喉科]