七氟烷与丙泊酚复合瑞芬太尼用于老年胃癌根治术中的麻醉效果  

Effects of Remifentanil Combined with Propofol or Sevoflurane in Gastrectomy for Elderly Gastric Cancer Patients

作　　者：朱洪宽 陈永伦 李超 ZHU Hongkuan;CHEN Yonglun;LI Chao(Department of Anesthesiology,The First People's Hospital of Qujing,Yunnan Qujing 655000)

机构地区：[1]曲靖市第一人民医院麻醉科,云南曲靖655000

出　　处：《医学临床研究》2024年第4期526-529,共4页Journal of Clinical Research

摘　　要：【目的】探讨七氟烷与丙泊酚复合瑞芬太尼在老年胃癌根治术患者中的应用效果。【方法】本院收治的100例老年胃癌手术治疗患者,随机分为两组,每组50例。观察组采用七氟烷复合瑞芬太尼麻醉,对照组采用丙泊酚复合瑞芬太尼麻醉,比较两组患者体征指标、应激指标、镇痛效果、术后恢复及不良反应发生情况。【结果】两组麻醉诱导前收缩压、舒张压、平均动脉压比较,差异均无统计学意义(P>0.05);切皮时,两组上述三项指标较诱导前均降低(P<0.05),且对照组低于观察组(P<0.05),拔管时三项指标水平均回升,但两组间比较,差异均无统计学意义(P>0.05)。两组术前肌钙蛋白(cTnI)、肌酸激酶同工酶(CK-MB)水平比较,差异无统计学意义(P>0.05),术中两指标较诱导前均升高(P<0.05),且观察组低于对照组(P<0.05)。观察组术后6 h、术后12 h、术后24 h疼痛视觉模拟评分(VAS)均低于对照组(P<0.05);观察组拔管时间、苏醒时间、恢复下床活动时间均短于对照组(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。【结论】七氟烷复合瑞芬太尼在老年胃癌患者中具有良好的麻醉效果,对患者血气及应激指标影响较小,且术后清醒时间短,镇痛效果良好,安全性高。【Objective】To explore the application of sevoflurane combined with propofol and remifentanil in elderly patients undergoing gastrectomy for gastric cancer.【Methods】A total of 100 elderly patients undergoing gastric cancer surgery at our hospital were randomly divided into two groups,with 50 patients in each group.The observation group received anesthesia with sevoflurane combined with remifentanil,while the control group received anesthesia with propofol combined with remifentanil.Vital signs,stress indicators,analgesic effects,postoperative recovery,and adverse reactions were compared between the two groups.【Results】There were no significant differences in systolic blood pressure,diastolic blood pressure,and mean arterial pressure levels between the two groups before anesthesia induction(P>0.05).At the time of skin incision,the levels of all three indicators decreased compared to before induction in both groups(P<0.05),with even lower level in the control group than in the observation group(P<0.05).The levels of all three indicators rebounded at the time of extubation,but there were no significant differences between the two groups(P>0.05).Preoperative levels of cardiac troponin I(cTnI)and creatine kinase-MB(CK-MB)showed no significant differences between the two groups(P>0.05).During surgery,both indicators increased compared to before induction(P<0.05),with lower levels in the observation group than in the control group(P<0.05).The observation group had lower visual analogue scale(VAS)pain scores at 6 hours,12 hours,and 24 hours postoperatively compared to the control group(P<0.05).The observation group also had shorter extubation time,awakening time,and time to resume out-of-bed activities compared to the control group(P<0.05).The incidence of adverse reactions in the observation group was lower than in the control group(P<0.05).【Conclusion】Sevoflurane combined with remifentanil provides good anesthetic effects in elderly gastric cancer patients,with minimal impact on blood gases and stress in

关 键 词：胃肿瘤/外科学 氟烷/药理学 二异丙酚 瑞芬太尼 

分 类 号：R735.2[医药卫生—肿瘤]