七氟醚和丙泊酚全身麻醉对肠梗阻合并感染性休克患者心功能及炎症反应的影响  

Effects of general anesthesia with sevoflurane and propofol on cardiac function and inflam-matory response in patients with intestinal obstruction and septic shock

作　　者：苏晓颜 万兆星[1] 郭正轩[2] SU Xiaoyan;WAN Zhaoxing;GUO Zhengxuan(Anesthesiology Department,Anyang District Hospital,Puyang City,Henan Province,Puyang,Henan,China,455000;Department of Oncology,Anyang District Hospital,Puyang City,Henan Province,Puyang,Henan,China,455000)

机构地区：[1]河南省濮阳市安阳地区医院麻醉科,河南濮阳455000 [2]河南省濮阳市安阳地区医院肿瘤科,河南濮阳455000

出　　处：《分子诊断与治疗杂志》2024年第1期59-62,67,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省医学教育研究项目(Wjlx2020475)。

摘　　要：目的观察七氟醚和丙泊酚全身麻醉对肠梗阻合并感染性休克患者心功能及炎症反应的影响。方法选取2020年3月至2022年12月在河南省濮阳市安阳地区医院行腹腔镜手术的肠梗阻合并感染性休克的患者84例,按照麻醉方式的不同分为七氟醚组和丙泊酚组,各42例,七氟醚组吸入2%的七氟醚,丙泊酚组静脉泵注射丙泊酚4 mg·kg^(-1)·h^(-1),分别比较两组患者不同时间段时血流动力学的变化,比较两组患者手术前后心功能指标变化,手术指标、氧化应激指标、炎症因子以及不良反应的变化。结果在T_(1)、T_(2)、T_(3)、T_(4)、T_(5)时,七氟醚组BDP、SBP、HR显著低于丙泊酚组(t=12.884、10.297、14.225、6.702、4.263、10.559、15.368、9.401、12.544、4.362、13.676、22.017、19.752、14.115、8.685,P均<0.001)。七氟醚组出血量、苏醒时间优于丙泊酚组,差异有统计学意义(t=2.875、2.331,P均<0.05)。术后七氟醚组NT-proBNP水平低于丙泊酚组,LVEF水平显著升高,七氟醚组高于丙泊酚组,差异有统计学意义(t=2.411、3.169,P均<0.05)。同一时间段(术后即刻、术后第1天、术后第3天、术后第5天)七氟醚组IL-6、IL-8、TNF-α水平低于丙泊酚组,差异有统计学意义(t=4.200、3.798、19.470、6.060、4.409、3.559、3.952、4.342、3.973、3.827、10.267、7.205,P均<0.001)。结论相对于丙泊酚组患者,吸入七氟醚对腹腔镜手术的肠梗阻合并感染性休克患者在改善心功能和减轻炎症反应方面效果更佳。Objective To observe the effects of general anesthesia with sevoflurane and propofol on cardiac function and inflammation in patients with intestinal obstruction and septic shock.Methods A total of 84 patients with intestinal obstruction complicated with septic shock who underwent laparoscopic surgery in Anyang District Hospital of Puyang City,Henan Province were selected,and divided into the sevoflurane group and the propofol group according to different anesthesia methods,42 cases each.The sevoflurane group inhaled 2%sevoflurane,in the propofol group,propofol 4 mg·kg^(-1)·h^(-1) was injected by intravenous pump.During the two groups of patients at different time periods,the changes in blood flow dynamics were compared,and the mental function index changes before and after surgery were compared.The surgical indicators,oxidation stress indicators,inflammatory factors,and adverse reactions were changed.Results At T_(1),T_(2),T_(3),T_(4) and T_(5),the BDP,SBP and HR in the sevoflurane group were significantly lower than those in the propofol group(t=12.884,10.297,14.225,6.702,4.263,10.559,15.368,9.401,12.544,4.362,13.676,22.017,19.752,14.115,8.685,P<0.001).The amount of bleeding and recovery time in the sevoflurane group were better than those in the propofol group,and the differences were statistically significant(t=2.875,2.331,P<0.05).After operation,the level of NT-proBNP in the sevoflurane group was lower than that in the propofol group,and the level of LVEF was significantly increased.The level of NT-proBNP in the sevoflurane group was higher than that in the propofol group,and the difference was statistically significant(t=2.411,3.169,P<0.05).The levels of IL-6,IL-8 and TNF-αin the sevoflurane group were lower than those in the propofol group at the same time period(immediately after operation,1 day after operation,3 days after operation and 5 days after operation),and the differences were statistically significant(t=4.200,3.798,19.470,6.060,4.409,3.559,3.952,4.342,3.973,3.827,10.267,7.205,P<0.001).Conclus

关 键 词：七氟醚 丙泊酚 肠梗阻 感染性休克 心功能 炎症因子 

分 类 号：R614[医药卫生—麻醉学]