瑞马唑仑对肝切除术患者术后苏醒质量及认知功能的影响  

Effects of Remimazolam on Recovery Quality and Postoperative Cognitive Dysfunction in Patients with Hepatectomy

作　　者：卓明[1] 刘金龙[1] 钟茂林[1] 王辉 黄可女 叶军明[1] ZHUO Ming;LIU Jinlong;ZHONG Maolin;WANG Hui;HUANG Kenü;YE Junming(Department of Anesthesiology,the First Affiliated Hospital of Gannan Medical University,Ganzhou 341000,China;不详)

机构地区：[1]赣南医学院第一附属医院麻醉科,江西赣州341000 [2]南昌县人民医院麻醉科,江西南昌330200

出　　处：《中国医学创新》2024年第5期46-50,共5页Medical Innovation of China

基　　金：赣州市2021年指导性科技计划项目(GZ2021ZSF076)。

摘　　要：目的:观察瑞马唑仑对肝切除术患者术后苏醒质量及认知功能的影响,探讨其临床价值。方法:选择赣南医学院第一附属医院2022年1月—2023年8月收治的需行肝切除手术患者60例,随机分为两组,对照组采取丙泊酚、芬太尼、顺阿曲库铵麻醉诱导,泵注丙泊酚、瑞芬太尼麻醉维持;观察组静脉注射苯磺酸瑞马唑仑、芬太尼、顺阿曲库铵麻醉诱导,泵注苯磺酸瑞马唑仑、瑞芬太尼麻醉维持。比较两组不同时刻生命体征、苏醒质量指标、术后认知功能,并测定血浆中枢神经特异性蛋白(S100β)、神经元特异性烯醇化酶(NSE)水平及统计两组不良反应发生情况。结果:两组入室后(T_(0))、麻醉诱导后(T_(1))、切皮时(T_(2))、手术1 h时(T_(3))、手术结束时(T_(4))、拔除气管导管时(T_(5))、出恢复室(T_(6))平均动脉压(MAP)及心率(HR),以及术前1 d、术后1 d、术后3 d简易智能量表(MMSE)评分、血浆S100β、NSE水平比较差异均无统计学意义(P>0.05);观察组T_(5)时刻的HR水平高于T_(0)时刻,差异有统计学意义(P<0.05)。观察组呼吸恢复时间、睁眼时间、拔管时间及恢复室停留时间均早于或者短于对照组,差异均有统计学意义(P<0.05),且观察组不良反应发生率(10.0%)低于对照组(33.3%),差异有统计学意义(P<0.05)。结论:瑞马唑仑应用于肝切除术患者苏醒时间短,且不影响认知功能,不良反应发生率更低。Objective:To observe the effects of Remimazolam on postoperative recovery quality and cognitive function in patients with hepatectomy,and to discuss its clinical value.Method:A total of 60 patients requiring hepatectomy admitted to the First Affiliated Hospital of Gannan Medical University from January 2022 to August 2023 were randomly divided into two groups.The control group was induced by Propofol,Fentanyl,Cisatracurium,and anesthesia maintained by pump injection of Propofol and Remifentanil.The observation group was induced by intravenous Remimazolam Tosilate,Fentanyl and Cisatracurium,and maintained by pump injection of Remimazolam Tosilate and Remifentanil.The vital signs,recovery quality indexes and postoperative cognitive function of the two groups were compared.The levels of plasma central nerve specific proteins(S100β)and neuronspecific enolase(NSE)were measured and the incidence of adverse reactions was statistically analyzed.Result:The mean arterial pressure(MAP)and heart rate(HR)after entry(T_(0)),after anesthesia induction(T_(1)),skin resection(T_(2)),1 h after operation(T_(3)),at the end of operation(T_(4)),at the time of tracheal catheter removal(T_(5)),and at leaving the recovery room(T_(6))had no significant differences,and MMSE scores,plasma S100βand NSE levels preoperative 1 d,postoperative 1 d,and postoperative 3 d had no significant differences(P>0.05);the HR level of the observation group at T_(5) was higher than that at T_(0),the difference was statistically significant(P<0.05).Respiratory recovery time,eye opening time,extubation time and recovery room residence time in the observation group were earlier or lower than those in the control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group(10.0%)was lower than that(33.3%)in the control group,the difference was statistically significant(P<0.05).Conclusion:Remimazolam can be used in patients undergoing hepatectomy with shorter recovery time,and it does not affect cogniti

关 键 词：瑞马唑仑 肝切除术 苏醒质量 认知功能 

分 类 号：R614[医药卫生—麻醉学]