BIS监测下丙泊酚微量泵输注对胃肠癌手术患者血流动力学及应激反应的影响  

Effect of propofol micropump infusion on hemodynamics and stress response in patients with gastric cancer surgery under BIS monitoring

作　　者：范军[1] 薛典福 王恒 王长城[1] 田景中[2] FAN Jun;XUE Dian-fu;WANG Heng;WANG Chang-cheng;TIAN Jing-zhong(Anhui Integrated Traditional Chinese and Western Medicine Hospital,Chuzhou 239000,China;Bozhou People′s Hospital,Bozhou 236000,China)

机构地区：[1]滁州市中西医结合医院麻醉科,安徽滁州239000 [2]亳州市人民医院胃肠外科,安徽亳州236000

出　　处：《实用药物与临床》2021年第4期334-337,共4页Practical Pharmacy and Clinical Remedies

基　　金：亳州市科技项目bzzc2019017。

摘　　要：目的观察脑电双频指数(BIS)监测对胃肠癌患者术中丙泊酚微量泵输注的调控作用,并观察患者的血流动力学及应激反应改变。方法选择安徽省滁州市中西医结合医院2017年1月至2019年12月收治的96例胃肠癌患者作为研究对象,采用随机数表法分为对照组和观察组,各48例。两组均行胃肠癌根治手术治疗,术中采用丙泊酚微量泵输注,对照组于术中手动调整丙泊酚用量,观察组于术中采用BIS监测,根据BIS值调整丙泊酚用量。分别于麻醉诱导前(T_(0))、手术开始30 min(T_(1))、手术结束时(T_(2)),检测并比较两组血流动力学[平均动脉压(MAP)、心率(HR)]、应激反应[甲状腺素(T4)、皮质醇(Cor)];记录两组用药期间不良反应。结果两组T_(1)、T_(2)时的MAP、HR水平均较T_(0)时降低,T_(2)时的MAP、HR均较T_(1)时降低,且观察组T_(1)、T_(2)时的MAP、HR均低于对照组,组间及各时点比较,差异有统计学意义(P<0.05);两组T_(1)、T_(2)时的T4、Cor均较T_(0)时升高,T_(2)时的T4、Cor均较T_(1)时升高,而观察组T_(1)、T_(2)时的T4、Cor均低于对照组,组间及各时点比较,差异有统计学意义(P<0.05);观察组不良反应发生率略低于对照组,而组间比较差异无统计学意义(P>0.05)。结论BIS监测在胃肠癌根治术手术患者术中麻醉监测中有较高的应用价值,可于术中全程控制患者血流动力学,减轻应激反应,值得临床推广应用。Objective To observe the regulation effect of Bispectral Index(BIS)monitoring on intraoperative propofol micropump infusion in patients with gastrointestinal cancer,and observe the changes in the patients′hemodynamics and stress response.Methods A total of 96 patients with gastric cancer treated in the Integrated Traditional Chinese and Western Medicine Hospital of Chuzhou City from January 2017 to December 2019 were selected as the research subjects.According to the random number table method,they were divided into a control group and an observation group,each with 48 cases.Both groups underwent radical resection of gastric cancer and were given propofol micropump infusion during the operation.In the control group the amount of propofol was adjusted manually during the operation,and in the observation group it was monitored by BIS during the operation.The amount of propofol was adjusted according to the BIS value.The hemodynamics[mean arterial pressure(MAP),heart rate(HR)]and stress response[thyroxine(T4),cortisol(Cor)]of the two groups were detected and compared before induction of anesthesia(T_(0)),30 minutes from the start of surgery(T_(1)),and at the end of surgery(T_(2));the adverse reactions during the medication of the two groups were recorded.Results The MAP and HR levels of the two groups at T_(1) and T_(2) were lower than those at T_(0),and the MAP and HR at T_(2) were lower than those at T_(1);the MAP and HR of the observation group at T_(1) and T_(2) were lower than those of the control group;there were significant differences between the two groups and among different time points(P<0.05).The T4 and Cor of the two groups at T_(1) and T_(2) were higher than those at T_(0),and the T4 and Cor at T_(2) were higher than those at T_(1);the T4 and Cor of the observation group at T_(1) and T_(2) were lower than those of the control group;there were significant differences between the two groups and among different time points(P<0.05).The incidence of adverse reactions in the observation group was slightly

关 键 词：胃肠癌 脑电双频指数 丙泊酚 微量泵输注 血流动力学 应激反应 

分 类 号：R614[医药卫生—麻醉学] R735[医药卫生—外科学]