老年腹腔镜下结肠癌切除术患者不同麻醉用药的应激反应观察  

Observation on stress response of elderly patients undergoing laparoscopic colon cancer resection under different anesthetics

作　　者：刘婷婷 LIU Ting-ting(Department of Anesthesia and Perioperative Medicine,Dongying Hospital of Traditional Chinese Medicine,Dongying 257055,China)

机构地区：[1]东营市中医院麻醉与围术期医学科,257055

出　　处：《中国实用医药》2024年第4期119-121,共3页China Practical Medicine

摘　　要：目的探讨老年腹腔镜下结肠癌切除术患者不同麻醉用药的应激反应。方法90例老年腹腔镜下结肠癌切除术患者作为研究对象,将其随机分为对照组和观察组,各45例。对照组应用丙泊酚进行麻醉,观察组应用丙泊酚依托咪酯混合剂进行麻醉。对比两组患者不良反应发生率、满意度及手术前后应激反应指标[醛固酮(ALD)、皮质醇(Cor)以及促肾上腺皮质激素(ACTH)]。结果观察组不良反应发生率为13.33%,对照组不良反应发生率为17.78%;两组不良反应发生率比较,差异无统计学意义(P>0.05)。术前,两组ALD、Cor、ACTH水平差异无统计学意义(P>0.05);术后,观察组ALD(120.38±11.32)pg/ml、Cor(204.32±17.38)μg/L以及ACTH(18.11±1.21)ng/L均低于对照组的(148.11±12.24)pg/ml、(226.11±19.21)μg/L、(25.11±2.24)ng/L,差异有统计学意义(P<0.05)。观察组满意度比对照组更高,差异不明显(P>0.05)。结论在老年腹腔镜腹下结肠癌切除术麻醉用药中,用丙泊酚依托咪酯混合剂发生的应激反应较单纯应用丙泊酚小,同时并未导致不良反应发生率增加,安全性较好。Objective To investigate the stress response of elderly patients undergoing laparoscopic colon cancer resection under different anesthetics.Methods 90 elderly patients with laparoscopic resection of colon cancer were studied,and they were randomly divided into a control group and an observation group,with 45 cases in each group.The control group was given propofol for anesthesia,and the observation group was given propofol etomidate mixture for anesthesia.The incidence of adverse reactions,satisfaction,stress response indicators[aldosterone(ALD),cortisol(Cor),and adrenocorticotropic hormone(ACTH)]before and after the surgery were compared between the two groups.Results The incidence of adverse reactions was 13.33%in the observation group and 17.78%in the control group.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Before the surgery,the levels of ALD,Cor and ACTH were not significantly different between the two groups(P>0.05).After the surgery,the observation group had ALD of(120.38±11.32)pg/ml,Cor of(204.32±17.38)μg/L and ACTH of(18.11±1.21)ng/L,which were lower than(148.11±12.24)pg/ml,(226.11±19.21)μg/L and(25.11±2.24)ng/L in the control group,and the difference was statistically significant(P<0.05).The satisfaction of the observation group was higher than that of the control group,but the difference was not significant(P>0.05).Conclusion Compared with propofol alone,propofol etomidate mixture causes a small stress response in elderly patients with laparoscopic resection of colon cancer without an increase in the incidence of adverse reactions and the safety is high.

关 键 词：麻醉用药 腹腔镜 结肠癌切除术 应激反应 

分 类 号：R614[医药卫生—麻醉学] R735.35[医药卫生—外科学]