梯度效应室靶控输注丙泊酚对双腔气管插管老年肺癌手术患者体循环和血流动力学的影响  

Effect of target-controlled infusion of propofol on systemic circulation and hemodynamics in elderlyypatients undergoing double-lumen endotracheal intubation in lung cancer surgery

作　　者：王军[1] 周丽丽[1] 杨垚 WANG Jun;ZHOU Li-li;YANG Yao(Department of Anesthesiology,Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250001,Shandong Province,China)

机构地区：[1]山东中医药大学第二附属医院麻醉科,山东济南250001

出　　处：《中国临床药理学杂志》2023年第17期2464-2468,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的 分析梯度效应室靶控输注(TCI)丙泊酚对双腔气管插管老年肺癌手术患者体循环和血流动力学的影响。方法 选取老年肺癌手术患者作为研究对象,用随机数字表法分为试验组和对照组,均进行气管插管全身麻醉,在麻醉诱导期对照组用血浆靶控输注丙泊酚,试验组用梯度效应室靶控输注丙泊酚。记录2组患者苏醒情况,对比其诱导前(T1)、诱导后气管插管前(T2)、气管插管时(T3)、插管后3 min(T4)体循环与血流动力学指标[心排指数(CI)、收缩压(SBP)、舒张压(DBP)、心率(HR)],对比其麻醉诱导前及术后1和3 d时炎症反应[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)],记录其麻醉相关药物不良反应。结果 试验组和对照组分别入组40例受试者。试验组和对照组的呼吸恢复时间分别为(3.54±0.38)和(7.65±0.79)min,苏醒时间分别为(4.57±0.56)和(10.26±1.18)min,拔管时间分别为(5.48±0.69)和(11.42±1.28)min,麻醉后监测治疗室(PACU)停留时间分别为(14.62±1.51)和(17.59±1.83)min,躁动评分分别为(1.15±0.18)和(2.23±0.26)分;T2时试验组和对照组CI分别为(3.26±0.33)和(3.09±0.35)L·min^(-1)·m^(-2),SBP分别为(131.06±13.57)和(140.25±14.86)mmHg, DBP分别为(79.31±8.12)和(84.39±8.56)mmHg, HR分别为(74.23±7.51)和(78.45±7.84)beat·min^(-1);术后3 d CRP分别为(93.12±9.82)和(117.11±12.73)mg·L^(-1),IL-6分别为(86.49±8.72)和(101.36±10.74)pg·mL^(-1),TNF-α分别为(18.96±2.13)和(23.45±2.67)pg·mL^(-1),试验组上述指标与对照组比较,差异均有统计学意义(均P<0.05)。试验组和对照组麻醉相关药物不良反应发生率分别为5.00%和20.00%,差异有统计学意义(P<0.05)。结论 梯度效应室靶控输注丙泊酚应用于双腔气管插管老年肺癌手术患者中,可提高苏醒质量,减少体循环及血流动力学波动,降低炎症反应与药物不良反应风险。Objective To analyze the effect of target-controlled infusion(TCI)of propofol on systemic circulation and hemodynamics in elderly patients undergoing double-lumen endotracheal intubation in lung cancer surgery.Methods Elderly patients who underwent lung cancer surgery were selected as the study subjects,and randomly divided into the treatment group and the control group by random number table method.All patients underwent general anesthesia via tracheal intubation.During anesthesia induction,the control group was given plasma TCI of propofol,while the treatment group was given gradient effect chamber TCI of propofol.Recovery of the two groups was recorded.Systemic circulation and hemodynamics indexes[cardiac index(CI),systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)] before induction(T1),before tracheal intubation(T2),at tracheal intubation(T3)and 3 min after intubation(T4),and inflammatory response[C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)] before anesthesia induction and on day 1 and day 3 after surgery were compared between groups.Anesthesia-related adverse drug reaction was recorded.Results The treatment group and the control group were enrolled in 40 subjects.The respiratory recovery time of the treatment group and the control group were(3.54±0.38)and(7.65±0.79)min;the awakening time were(4.57±0.56)and(10.26±1.18)min;the extubation time were(5.48±0.69)and(11.42±1.28)min,the length of post-anesthesia care unit(PACU)stay were(14.62±1.51)and(17.59±1.83)min;the agitation scores were 1.15±0.18 and 2.23±0.26;CI at T2 were(3.26±0.33)and(3.09±0.35)L·min^(-1).m^(-2);SBP were(131.06±13.57)and(140.25±14.86)mmHg;DBP were(79.31±8.12)and(84.39±8.56)mmHg;HR were(74.23±7.51)and(78.45±7.84)beat·min-1;CRP level on day 3 after surgery were(93.12±9.82)and(117.11±12.73)mg·L^(-1);IL-6 level were(86.49±8.72)and(101.36±10.74)pg·mL^(-1);TNF-αlevel were(18.96±2.13)and(23.45±2.67)pg·mL^(-1);the incidence rates of anesthesia-related complica

关 键 词：丙泊酚 肺癌 老年 体循环 血流动力学 

分 类 号：R971.2[医药卫生—药品]