地佐辛联合丙泊酚麻醉在胃癌根治术患者中的应用效果  

Application effects of Dezocine combined with Propofol anesthesia in patients undergoing radical gastrectomy

作　　者：董晓辉[1] 王琦博 张轩宇 DONG Xiaohui;WANG Qibo;ZHANG Xuanyu(Department of Anesthesiology of Shangqiu First People’s Hospital,Shangqiu 476200 Henan,China)

机构地区：[1]商丘市第一人民医院麻醉科,河南商丘476200

出　　处：《中国民康医学》2024年第8期51-53,57,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察地佐辛联合丙泊酚麻醉在胃癌根治术患者中的应用效果。方法:选取2019年5月至2022年5月该院收治的92例胃癌根治术患者进行前瞻性研究,按照随机数字表法将其分为对照组与观察组各46例。对照组采用芬太尼联合丙泊酚麻醉,观察组采用地佐辛联合丙泊酚麻醉,比较两组不同时间[麻醉诱导前(T_(0))、术后0.5 h(T_(1))、术毕(T_(2))]血流动力学指标[平均动脉压(MAP)、心率]水平,手术前后应激反应指标(皮质醇、促肾上腺皮质激素)水平、认知功能[简易精神状态检查量表(MMSE)]评分,以及不良反应发生率。结果:T_(0)、T_(1)、T_(2)时,两组MAP、心率呈先降低后升高的趋势,T_(0)、T_(2)时,两组MAP、心率水平比较,差异均无统计学意义(P>0.05);T_(1)时,观察组心率、MAP水平均高于对照组,差异有统计学意义(P<0.05);术后24 h,两组皮质醇、促肾上腺皮质激素水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);术后24 h,两组MMSE评分均低于术前,但观察组高于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论:地佐辛联合丙泊酚麻醉可提高胃癌根治术患者认知功能评分和血流动力学指标水平,降低应激反应指标水平和不良反应发生率,其效果优于芬太尼联合丙泊酚麻醉。Objective:To observe application effects of Dezocine combined with Propofol anesthesia in patients undergoing radical gastrectomy.Methods:A prospective study was conducted on 92 patients undergoing radical gastrectomy admitted to the hospital from May 2019 to May 2022.According to the random number table method,they were divided into control group and observation group,46 cases in each group.The control group was anesthetized with Fentanyl combined with Propofol,while the observation group was anesthetized with Dezocine combined with Propofol.The levels of hemodynamic indexes[mean arterial pressure(MAP),heart rate]and stress response indexes(cortisol,adrenocorticotropic hormone)at different time[before anesthesia induction(T_(0)),0.5 h after the surgery(T_(1)),end of the surgery(T_(2))],the cognitive function[mini-mental state examination(MMSE)],and the incidence of adverse reactions were compared between the two groups.Results:At T_(0),T_(1)and T_(2),the MAP and heart rate of the two groups decreased and then increased.At T_(0)and T_(2),there were no statistically significant differences in MAP and heart rate levels between the two groups(P>0.05).At T_(1),the heart rate and MAP level of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).24 h after the surgery,the levels of cortisol and adrenocorticotropic hormone in the two groups were higher than those before operation,but those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).24 h after the surgery,the MMSE scores of the two groups were lower than those before the surgery,but that in the observation group was higher than that in the control group,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusions:Dezocine combined with Propofol anesthes

关 键 词：胃癌根治术 丙泊酚 地佐辛 血流动力学 认知功能 应激反应 不良反应 

分 类 号：R614[医药卫生—麻醉学]