不同剂量甲苯磺酸瑞马唑仑对经肠道内镜黏膜下剥离术者抗感染效果分析  

Analysis of the anti-infective effect of different doses of remazolam tosylate on patients undergoing endoscopic submucosal dissection

作　　者：朱伟波[1] 于建民[1] 王建越[1] 付艳红[1] 秦海艳[1] 高娜 ZHU Wei-bo;YU Jian-min;WANG Jian-yue(Department of Anesthesiology,Binzhou Municipal People's Hospital,Binzhou Shandong 256600,China)

机构地区：[1]滨州市人民医院麻醉科,山东滨州256600

出　　处：《临床和实验医学杂志》2022年第22期2462-2464,F0003,共4页Journal of Clinical and Experimental Medicine

基　　金：2020年山东省医学会舒适化医疗科研基金(编号:YXH2020ZX030)。

摘　　要：目的分析不同剂量甲苯磺酸瑞马唑仑对经肠道内镜黏膜下剥离术者抗感染效果。方法采用前瞻性分析的研究方法,选取2020年1月至2020年12月在滨州市人民医院进行经肠道内镜黏膜下剥离术治疗的60例患者进行研究,所有患者均采用随机数字表法分为3组,每组各20例。A组给予10μg舒芬太尼+0.1 mg/kg甲苯磺酸瑞马唑仑,B组给予10μg舒芬太尼+0.15 mg/kg甲苯磺酸瑞马唑仑,C组给予10μg舒芬太尼+0.2 mg/kg甲苯磺酸瑞马唑仑,各组均依据实际情况追加甲苯磺酸瑞马唑仑2.5 mg/次,15 min内追加不超过5次。比较3组患者麻醉前5 min(T0)、进肠镜时(T1)、标记肿瘤边缘时(T2)、黏膜下切除肿瘤时(T3)、术毕时(T4)的心率、舒张压、收缩压、脉搏血氧饱和度(SpO_(2))、呼吸频率的变化情况;记录3组患者甲苯磺酸瑞马唑仑用量、用药后至脑电双频指数(BIS)评分≤70分的时间,停药后至麻醉唤醒时间、离室时间、麻醉后不良反应情况、肝肾功能情况。结果T0~T4间3组患者的心率、舒张压、收缩压、呼吸频率均呈现先降低后升高的趋势,且T1~T4间B组和C组的心率、舒张压、收缩压、呼吸频率均低于A组,差异均有统计学意义(P<0.05);但T0~T4间3组患者的SpO_(2)水平和T1~T4间B组和C组的心率、舒张压、收缩压、呼吸频率比较差异均无统计学意义(P>0.05)。B组和C组的甲苯磺酸瑞马唑仑用量、用药后至BIS评分≤70分时间、停药后至麻醉唤醒时间、离室时间均少于A组,且B组甲苯磺酸瑞马唑仑用量、停药后至麻醉唤醒时间、离室时间均少于C组,差异均有统计学意义(P<0.05)。B组和C组的血胆红素升高、头晕/头痛发生率均低于A组,B组的低血压、心动过缓发生率均低于A组和C组,差异均有统计学意义(P<0.05)。停药后B组的血清天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)、尿素氮、血肌酐水平均低于A组�Objective To analyze the anti-infection effects of different doses of remazolam tosylate on patients undergoing enteroscopic submucosal dissection.Methods By using the method of prospective analysis research from January 2020 to December 2020 to Binzhou Municipal People's Hospital during the period of the treatment of intestinal endoscopic submucosal dissection of 60 patients,all patients were divided into three groups by random number table method,each 20 cases.Group A was given 10μg sufentanil+0.1 mg/kg remazolam tosylate,group B was given 10μg sufentanil+0.15 mg/kg remazolam tosylate,and group C was given 10μg sufentanil fentanyl+0.2 mg/kg remazolam tosylate,each group was additionally supplemented with remazolam tosylate 2.5 mg/time according to the actual situation,no more than 5 additional times within 15 minutes.The changes of heart rate,diastolic blood pressure,systolic blood pressure,pulse oxygen saturation(SpO_(2))and respiratory rate 5 min before anesthesia(T0),colonoscopy(T1),tumor margin labeling(T2),submucosal tumor resection(T3),and postoperative(T4)were compared between the three groups.The dosage of remazolam tosylate,the time after drug administration to bispectral index(BIS)score≤70 points,the time after drug withdrawal to anesthesia wake-up time,the time of leaving the chamber,the adverse reactions after anesthesia,liver and kidney functional status in the three groups were recorded.Results Heart rate,diastolic blood pressure,systolic blood pressure and respiratory rate of the three groups from T0 to T4 decreased first and then increased,and heart rate,diastolic blood pressure,systolic blood pressure and respiratory rate of the three groups from T1 to T4 were lower than that of the group A,the differences were statistically significant(P<0.05).However,there were no significant differences in SpO_(2) levels among T0-T4 groups and heart rate,diastolic blood pressure,systolic blood pressure and respiratory rate among T1-T4 groups B and C(P>0.05).The dosage of remazolam tosylate,the time from

关 键 词：经肠道内镜黏膜下剥离术 甲苯磺酸瑞马唑仑 血流动力学 不良反应 肝肾损伤 术后院内感染 

分 类 号：R614[医药卫生—麻醉学]