丙泊酚注射剂联合瑞芬太尼注射剂用于宫颈癌根治术老年患者的临床研究  

Clinical trial of propofol injection combined with remifentanil injection in the treatment of elderly patients with radical resection of cervical cancer

作　　者：王菁[1] 魏颖[1] 张龙新[1] 肖培汉 张陈枝[2] 周敏[1] 黄仰发[3] WANG Jing;WEI Ying;ZHANG Long-xin;XIAO Pei-han;ZHANG Chen-zhi;ZHOU Min;HUANG Yang-fa(Department of Anesthesiology,Fujian Maternity and Child Health Hospital,Affiliated Hospital of Fujian Medical University,Fuzhou 350001,Fujian Province,China;Clinical Pharmaceutical Laboratory,Department of Pharmacy,First Affiliated Hospital of Fujian Medical University,Fuzhou 350004,Fujian Province,China;Department of Anesthesiology,Union Hospital Affiliated to Fujian Medical University,Fuzhou 350002,Fujian Province,China)

机构地区：[1]福建省妇幼保健院福建医科大学附属医院麻醉科,福建福州350001 [2]福建医科大学附属第一医院药学部临床药学实验室,福建福州350004 [3]福建医科大学附属协和医院麻醉科,福建福州350002

出　　处：《中国临床药理学杂志》2022年第11期1177-1180,共4页The Chinese Journal of Clinical Pharmacology

基　　金：福建省科技软科学基金资助项目(2018R0042)。

摘　　要：目的观察在脑电双频指数(BIS)监护仪下丙泊酚注射剂联合瑞芬太尼注射剂靶控输注用于宫颈癌根治术老年患者的临床疗效及安全性。方法将72例择期进行宫颈癌根治术的老年患者随机分为对照组和试验组,每组36例。在肌松药起效后,对照组进行气管插管,给予3.5μg·mL^(-1)丙泊酚+5.5 ng·mL^(-1)瑞芬太尼进行麻醉维持;试验组连接BIS监护仪,当BIS<60进行气管插管,通过调节丙泊酚、瑞芬太尼靶控输注速度进行麻醉维持,2种药物浓度均以0.5μg·mL^(-1)为递增或递减梯度,每个目标靶浓度输注1 min,使BIS维持在45~55。比较2组患者的血清单核细胞趋化蛋白-1(MCP-1)和谷胱甘肽过氧化物酶(GSH-Px)水平,以及药物不良反应的发生情况。结果术后,试验组和对照组的血清MCP-1分别为(221.11±18.34)和(663.04±53.42)pg·mL^(-1),血清GSH-Px分别为(1711.94±113.42)和(1972.64±110.52)U·mL^(-1),差异均有统计学意义(均P<0.05)。2组患者的药物不良反应均以躁动不安、恶心呕吐和心动过缓为主。试验组和对照组的总药物不良反应分别为8.33%和13.89%,差异无统计学意义(P>0.05)。结论丙泊酚注射剂联合瑞芬太尼注射剂靶控输注用于宫颈癌根治术老年患者可减轻机体应激反应和炎症反应,且不增加药物不良反应的发生率。Objective To observe the clinical efficacy and safety of propofol injection combined with remifentanil injection target-controlled infusion in the treatment of elderly patients with radical resection of cervical cancer by bispectral index(BIS)monitor.Methods A total of 72 elderly patients with radical resection of cervical cancer were randomly divided into control and treatment groups with 36 cases per group.After the muscle relaxants took effect,the control group was performed tracheal intubation and given 3.5μg·mL~(-1)propofol+5.5 ng·mL~(-1)remifentanil for maintenance of anesthesia;the treatment group was connected to BIS monitor,endotracheal intubation was performed after the BIS<60,anesthesia was maintained by adjusting the target controlled infusion rate of propofol and remifentanil,the concentration of the two drugs was increased or decreased gradient by 0.5μg·mL^(-1),each target concentration was infused for 1 min to kept the BIS at 45 to 55.The levels of serum monocyte chemotactic protein 1(MCP-1)and glutathione peroxidase(GSH-Px),and adverse drug reactions were compared between two groups.Results After operation,the serum MCP-1 levels of treatment and control groups were(221.11±18.34)and(663.04±53.42)pg·mL^(-1),serum GSH-Px were(1711.94±113.42)and(1972.64±110.52)U·mL^(-1),the differences were statistically significant(all P<0.05).The adverse drug reactions of two groups were restlessness,nausea,vomiting and bradycardia.The total incidences of adverse drug reactions in the treatment and control groups were 8.33%and 13.89%,without significant difference(P>0.05).Conclusion Propofol injection combined with remifentanil injection target-controlled infusion can inhibit the stress and inflammatory reactions of elderly patients with radical resection of cervical cancer,without increasing the incidence of adverse drug reactions.

关 键 词：丙泊酚注射剂 瑞芬太尼注射剂 靶控输注 老年 宫颈癌根治术 安全性评估 

分 类 号：R971.2[医药卫生—药品]