丙泊酚麻醉应用于食管癌内镜黏膜下剥离术中的有效性及对患者纤维蛋白原和D-二聚体的影响  被引量:10

Effectiveness of Propofol Anesthesia in Endoscopic Submucosal Dissection for Esophageal Cancer and the Influence on Serum Levels of Fibrinogen and D-dimer

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作  者:丁汉琳[1] 金胜[1] 

机构地区:[1]湖北省襄阳市中心医院,441021

出  处:《实用癌症杂志》2018年第3期405-407,411,共4页The Practical Journal of Cancer

摘  要:目的观察丙泊酚麻醉应用于食管癌内镜黏膜下剥离术中的有效性以及对患者血清纤维蛋白原和D-二聚体水平的影响。方法选取食管癌患者89例,根据患者麻醉方法不同分为对照组44例和观察组45例。对照组患者应用维库溴铵和芬太尼进行麻醉;观察组在对照组基础上给予持续静脉泵入丙泊酚;2组患者均采取内镜黏膜下剥离术(ESD)。比较2组手术时间、术中出血量及住院时间;记录2组患者1个月随访期间并发症发生情况。比较2组术后Ransay和视觉模拟疼痛评分(VAS)。检测2组血清中纤维蛋白原和D-二聚体水平。结果观察组患者的手术时间、术中出血量及住院时间均显著少于对照组(P<0.01)。对照组患者并发症发生率为11.36%,观察组患者并发症发生率为4.44%,差异无统计学意义(P>0.05)。术后6 h,观察组患者的Ransay评分显著高于对照组,VAS评分显著低于对照组(P<0.01)。术后6 h,观察组患者血清中纤维蛋白原和D-二聚体水平显著低于对照组,差异有统计学意义(P<0.01)。结论在食管癌内镜黏膜下剥离术中加用丙泊酚麻醉效果确切,安全性好,且可降低患者血清纤维蛋白原和D-二聚体水平。Objective To observe the effectiveness of propofol anesthesia in endoscopic submucosal dissection for esophageal cancer and its influence on serum levels of Fibrinogen and D-dimer. Methods 89 patients with esophageal cancer were randomly divided into the control group(44 cases) and the observation group(45 cases) according to different anesthesia methods. The control group was given vecuronium bromide and fentanyl anesthesia. Based on the control group, the observation group was given intravenously continuous pumping of propofol. Both groups were treated with endoscopic submucosal dissection(ESD). Time of operation,intraoperative blood loss, and hospital stays were compared between the 2 groups. Complications were recorded during 1 month follow-up in the 2 groups. Scores of Ransay and Visual analog pain scale(VAS) were compared in the 2 groups. Serum levels of Fibrinogen and D-dimer were detected in the 2 groups. Results Time of operation,intraoperative blood loss, and hospital stays of the observation group were obviously lower than those of the control group ( P 〈 0.01 ). The complication inci- dence of the observation group was 4.44%, which had no statistically significant difference compared with the control group, 11.36% (P 〉 0.05). After 6 h of operation, Ransay score of the observation group was remarkably higher, while VAS score was lower than the control group (P 〈 0.01 ). After 6 h of operation, serum levels of Fibrinogen and D-dimer of the observation group were lower than the control group, with statistically significant difference ( P 〈 0.01 ). Conclusion The application of propofol anesthesia in endoscopic submucosal dissection for esophageal cancer is effective and safe, and can decrease serum levels of Fibrinogen and D-dimer.

关 键 词:丙泊酚 食管癌 内镜黏膜下剥离术 纤维蛋白原 D-二聚体 

分 类 号:R735.1[医药卫生—肿瘤]

 

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