瑞芬太尼与丙泊酚用于老年开胸手术中的效果  

Effects of Remifentanil and Propofol an Thoracic Surgery in the Elderly

作　　者：李端非 黎逢球 LI Duanfei;LI Fengqiu(Department of Anesthesiology, Xianning Central Hospital, The First Affiliated Hospital of Hubei University of Science And Technology, Xianning Hubei 437100, China)

机构地区：[1]湖北省咸宁市中心医院/湖北科技学院附属第一医院麻醉科

出　　处：《中国继续医学教育》2019年第25期103-105,共3页China Continuing Medical Education

摘　　要：目的研究老年开胸手术中选择瑞芬太尼复合丙泊酚麻醉的效果。方法选择本院2016 年1 月—2018 年6 月中的200 例老年开胸手术患者,按照手术麻醉方式分组,观察组100 例实施瑞芬太尼复合丙泊酚麻醉,对照组100 例接受芬太尼复合丙泊酚麻醉,比较麻醉效果。结果观察组T0-T3 时间点心率、平均动脉压均与对照组明显不差异,P >0.05;观察组术后3 小时~ 48 小时认知功能评分均高于对照组,P < 0.05;观察组术后24 h 白细胞介素-6、C 反应蛋白、肿瘤坏死因子-α水平均低于对照组,P < 0.05。结论老年开胸手术应用瑞芬太尼复合丙泊酚能够减轻患者围术期应激反应、炎症反应,减小对认知功能的影响。Objective To study the anesthetic effect of remifentanil combined with propofol in elderly thoracotomy. Methods 200 elderly patients who underwent thoracotomy in the period from January 2016 to June 2018 were selected and divided into groups according to surgical anesthesia. 100 patients in the observation group were treated with remifentanil combined with propofol anesthesia, and 100 patients in the control group were treated with fentanyl combined with propofol anesthesia, and the anesthetic effect was compared. Results the heart rate and mean arterial pressure of the observation group at T0 - T3 time point were not significantly different from those of the control group, P > 0.05. The cognitive function score of the observation group was higher than that of the control group (P < 0.05). The levels of interleukin-6, c-reactive protein, and tumor necrosis factor-alpha were all lower in the observation group than in the control group at 24 h after surgery, P < 0.05. Conclusion The application of remifentanil combined with propofol in elderly thoracotomy can alleviate perioperative stress and inflammation and reduce the impact on cognitive function, which can be popularized.

关 键 词：老年开胸手术 瑞芬太尼 丙泊酚 应激反应 炎症反应 认知功能 

分 类 号：R614[医药卫生—麻醉学]