不同剂量舒芬太尼复合丙泊酚靶控输注对面部美容手术患者围术期血液循环、Th17/Treg及苏醒质量的影响  

Effects of Target Controlled Infusion of Different Doses of Sufentanil Combined with Propofol on Perioperative Blood Circulation,Th17/Treg and Recovery Quality in Patients undergoing Facial Plastic Surgery

作　　者：姜全威 薛志强 刘丽霞 王东伟[2] JIANG Quanwei;XUE Zhiqiang;LIU Lixia;WANG Dongwei(Department of Anesthesiology,Benxi Central Hospital,Benxi 117000,Liaoning,China;Department of Anesthesiology,the First Affiliated Hospital of Jiamusi University,Jiamusi 154000,Heilongjiang,China)

机构地区：[1]本溪市中心医院麻醉科,辽宁本溪117000 [2]佳木斯大学附属第一医院麻醉科,黑龙江佳木斯154000

出　　处：《中国美容医学》2022年第8期59-62,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨不同剂量舒芬太尼复合丙泊酚靶控输注对面部美容手术患者围术期血液循环、Th17/Treg及苏醒质量的影响。方法:选取面部美容手术患者100例,采用数字表法随机分为A组与B组,每组50例。先静脉注射咪达唑仑0.03 mg/kg,5 min后A组采用0.1μg/kg的舒芬太尼复合丙泊酚靶控输注辅助麻醉,B组采用0.15μg/kg的舒芬太尼复合丙泊酚靶控输注辅助麻醉。观察静脉注射咪达唑仑5 min后(T0)、静脉注射舒芬太尼5 min后(T1)、局部麻醉开始时(T2)、局部麻醉完成时(T3)的心率(HR)、平均动脉压(MAP)及脉搏血氧饱和度(SpO_(2)),比较术前、术后3 d Th17、Treg水平,采用Steward苏醒评分对苏醒质量进行评价。结果:两组T0、T1时HR、MAP、SpO_(2)水平比较差异无统计学意义(P>0.05)。T2时HR及SpO_(2)水平比较差异无统计学意义(P>0.05),A组MAP低于B组,差异有统计学意义(P<0.05)。T3时MAP及SpO_(2)水平比较差异无统计学意义(P>0.05);A组HR低于B组,差异有统计学意义(P<0.05)。两组不同时间HR及MAP组内比较差异有统计学意义(P<0.05);SpO_(2)水平组内比较差异无统计学意义(P>0.05)。两组术前及术后3 d Th17及Treg细胞水平比较差异无统计学意义(P>0.05);术后3 d两组Th17及Treg细胞水平低于术前,差异有统计学意义(P<0.05)。B组Steward苏醒评分高于A组,差异有统计学意义(P<0.05)。结论:面部美容手术患者采用舒芬太尼复合丙泊酚靶控输注时,舒芬太尼剂量的适当增加不会对围术期血液循环及Th17/Treg形成明显影响,但0.15μg/kg舒芬太尼更有助提高苏醒质量。Objective To investigate the effects of blood circulation,Th17/Treg and anesthesia recovery quality during perioperative period of target controlled infusion of different doses of sufentanil combined with propofol in facial plastic surgery patients.Methods 100 cases facial plastic surgery patients as the research object,they were randomly divided into the group A(n=50)and the group B(n=50).Midazolam 0.03 mg/kg was injected intravenously first.The group A was treated with sufentanil(0.1μg/kg)combined with propofol by target controlled infusion as auxiliary anesthesia,the group B was treated with sufentanil(0.15μg/kg)combined with propofol by target controlled infusion as auxiliary anesthesia.The levels of heart rate(HR),mean arterial pressure(MAP)and pulse oxygen saturation(SpO_(2)) were observed and recorded at 5 min after intravenous midazolam(T0),5 min after intravenous sufentanil(T1),the beginning of local anesthesia(T2)and the completion of local anesthesia(T3).Th17 and Treg levels were compared before and 3 days after operation.And the anesthesia recovery quality was evaluated by Steward awakening score.Results There were no significant difference in HR,MAP and SpO_(2) between the two groups at T0 and T1(P>0.05).There were no significant difference in HR and SpO_(2) between two groups at T2(P>0.05).MAP in the group A was lower than that in the group B,and the difference was statistically significant(P<0.05).There were no significant difference in MAP and SpO_(2) between the two groups at T3(P>0.05).The HR of the group A was lower than that of the group B(P<0.05).There were significant difference in HR and MAP between the two groups at different times(P<0.05).There were no significant difference in SpO_(2) level between the two groups at different times(P>0.05).There were no significant difference in Th17 and Treg cells between the two groups before and 3 d after surgery(P>0.05).The levels of Th17 and Treg cells at 3 d after operation were lower than those before operation in the two groups(P<0.05).Steward�

关 键 词：舒芬太尼 丙泊酚 靶控输注 面部美容手术 血液循环 TH17/TREG 苏醒质量 

分 类 号：R622[医药卫生—整形外科]