CONCERT-CL闭环靶控输注系统对腹腔镜胃肠手术患者术后胃肠功能及免疫功能的影响  

Effect of CONCERT-CL closed loop target control infusion system on gastrointestinal function and immune function after laparoscopic gastrointestinal surgery

作　　者：王芳琪 雷林军 付茂璟 魏子钦 王晓敏 谢妍[1] WANG Fang-qi;LEI Lin-jun;FU Mao-jing;WEI Zi-qin;WANG Xiao-min;XIE-Yan(Department of Anesthesiology Shanghai Xuhui District Central Hospital,Shanghai 200031,CHINA)

机构地区：[1]上海市徐汇区中心医院麻醉科,上海200031

出　　处：《海南医学》2024年第5期641-645,共5页Hainan Medical Journal

基　　金：上海市徐汇区卫生健康系统高原学科建设资助项目(编号:SHXHZDXK202324)。

摘　　要：目的 探讨CONCERT-CL闭环靶控输注系统在腹腔镜胃肠手术患者中的应用效果及对患者术后胃肠功能和免疫功能的影响。方法 选取2022年8月至2023年5月上海市徐汇区中心医院收治的80例腹腔镜胃肠手术患者作为研究对象,按随机数表法分为观察组和对照组各40例。两组患者均采用相同的麻醉方案,但观察组患者采用CONCERT-CL闭环靶控输注系统进行麻醉管理,而对照组患者则采用开放式麻醉维持。比较两组患者的围术期相关指标、胃肠功能和围术期白细胞分化抗原(CD) TT细胞数量和自然杀伤细胞(NK)细胞数量,同时比较两组患者术后不良反应发生情况。结果 观察组患者的手术时间、麻醉时间分别为(183.60±30.15) min、(206.69±10.54) min,对照组分别为(189.12±43.85) min、(211.65±16.83) min,差异均无统计学意义(P>0.05);观察组患者术中丙泊酚用量和顺式阿曲库铵用量分别为(13.34±2.00) mg/kg、(0.26±0.09) mg/kg,明显低于对照组的(15.96±1.41) mg/kg、(0.35±0.11) mg/kg,拔管即刻警觉-镇静(OAA/S)评分和术中BIS时间为40~60的占比分别为(3.46±0.25)分、(82.60±4.22)%,明显高于对照组的(3.12±0.46)分、(64.02±3.65)%,差异均有统计学意义(P<0.05);观察组和对照组患者的肠鸣音恢复[(22.60±4.52) h vs (30.57±6.84) h]、腹痛缓解[(26.88±4.11) h vs (30.17±2.94) h]、术后首次排气时间[(32.69±4.25) h vs (44.35±1.68) h]比较,观察组明显短于对照组,差异均有统计学意义(P<0.05);术后12 h,观察组和对照组患者的CD4+TT数量[(35.69±1.54)%vs (32.01±6.21)%]、NK细胞数量[(20.36±2.41)%vs (18.73±2.65)%]比较,观察组明显高于对照组,CD8+TT数量[(27.01±1.79)%vs (29.28±3.87)%]比较,观察组明显低于对照组,差异均有统计学意义(P<0.05);观察组患者的不良反应总发生率为5.00%,略低于对照组的10.00%,但差异无统计学意义(P>0.05)。结论 CONCERT-CL闭环靶控输注系统在腹腔镜胃肠手术患者�Objective To investigate the effect of CONCERT-CL closed loop target control infusion system on postoperative gastrointestinal function and immune function in patients undergoing laparoscopic gastrointestinal surgery.Methods From August 2022 to May 2023,80 patients with laparoscopic gastrointestinal surgery in Shanghai Xuhui District Central Hospital were selected and divided into the observation group(40 cases) and the control group(40 cases) according to random number table method.The two groups were given the same anesthesia regimen,while the observation group was administered anesthesia using the CONCERT-CL closed loop target control infusion system,and the control group was maintained with open anesthesia.The perioperative relevant indexes,gastrointestinal function,the number of TT cells of cluster of differentiation(CD),and the number of natural killer cell(NK) cells were compared between the two groups,and the occurrence of postoperative adverse reactions were compared between the two groups.Results There was no statistically significant difference in operation time and anesthesia time between the observation group and the control group:(183.60±30.15) min vs(189.12±43.85) min,(206.69±10.54) min vs(211.65±16.83) min(P>0.05).The intraoperative dosage of propofol and cis-atracurium in the observation group were(13.34±2.00) mg/kg and(0.26±0.09) mg/kg,significantly lower than(15.96±1.41) mg/kg and(0.35±0.11) mg/kg in the control group;the score of observer's assessment of alertness/sedation(OAA/S) and proportion of BIS time of 40-60 in the observation group were(3.46±0.25) points,(82.60±4.22)%,significantly higher than(3.12±0.46) min and(64.02±3.65)% in the control group;the differences were statistically significant(P<0.05).Compared with that in the control group,the recovery of bowel sound [(22.60±4.52) h vs(30.57±6.84) h],abdominal pain relief [(26.88±4.11) h vs(30.17±2.94) h],first postoperative exhaust time [(32.69±4.25) h vs(44.35±1.68) h] in the observation group was shorter,with statis

关 键 词：CONCERT-CL闭环靶控输注系统 腹腔镜胃肠手术 麻醉患者 胃肠功能 免疫功能 

分 类 号：R656.6[医药卫生—外科学]