艾司氯胺酮复合麻醉对胸腔镜肺叶切除术患者术中血流动力学的影响  

The Effect of Esketamine Combined Anesthesia on Hemodynamics in Patients Undergoing Thoracoscopic Lobectomy

作　　者：金黛丽 李继峰 刘洪亮 JIN Daili;LI Jifeng;LIU Hongliang(Department of Anesthesiology,Hebi People’s Hospital,Hebi Henan 458000,China)

机构地区：[1]鹤壁市人民医院麻醉科,河南鹤壁458000

出　　处：《临床研究》2024年第9期69-72,共4页Clinical Research

摘　　要：目的研究艾司氯胺酮复合麻醉对胸腔镜肺叶切除术患者的影响。方法将鹤壁市人民医院2022年5月至2023年12月接收的62例行胸腔镜肺叶切除术的肺癌患者按随机排列表法均分为对照组(静吸复合麻醉)与研究组(艾司氯胺酮+静吸复合麻醉),比较两组麻醉诱导前10 min(T_(0))、麻醉诱导后10 min(T_(1))、切皮后10 min(T_(2))及术毕(T_(3))的血流动力学指标,术前1 h及术后1 h应激指标、炎症因子水平,术后1 h、术后3 h、术后6 h疼痛评分以及并发症发生率。结果T_(0)时刻,两组平均动脉压与心率基本一致,差异无统计学意义(P>0.05);T_(1)~T_(3)时刻,研究组平均动脉压与心率均高于对照组,差异有统计学意义(P<0.05);两组T_(0)~T_(3)期间平均动脉压与心率平均动脉压与心率均处于正常范围内,两组异常率比较差异无统计学意义(P>0.05)。术前1 h,两组去甲肾上腺素(NE)、皮质醇(COR)水平基本一致,差异无统计学意义(P>0.05);术后1 h,研究组NE、COR水平低于对照组,差异有统计学意义(P<0.05);研究组术后1 h的NE、COR异常率均低于对照组,差异有统计学意义(P<0.05)。术后1 h、3 h、6 h,研究组疼痛评分均低于对照组,差异有统计学意义(P<0.05)。术前1 h,两组C反应蛋白(CRP)、白介素-6(IL-6)水平基本一致,差异无统计学意义(P>0.05);术后1 h,研究组CRP、IL-6水平低于对照组,差异有统计学意义(P<0.05);研究组术后1 h的CRP、IL-6异常率均低于对照组,差异有统计学意义(P<0.05)。研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论对胸腔镜肺叶切除术患者实施艾司氯胺酮复合麻醉,有助于维持其血流动力学稳定,减轻机体应激反应,缓解术后疼痛程度,抑制炎症反应,同时预防多种并发症,应用价值较高。Objective To study the effect of esketamine combined anesthesia on patients undergoing thoracoscopic lobectomy.Methods Sixty-two lung cancer patients who underwent thoracoscopic lobectomy at Hebi People’s Hospital from May 2022 to December 2023 were randomly divided into a control group(intravenous-inhalation combined anesthesia)and a study group(esketamine+intravenous-inhalation combined anesthesia).Hemodynamic indicators were compared between the two groups at 10 minutes before anesthesia induction(T_(0)),10 minutes after anesthesia induction(T_(1)),10 minutes after skin incision(T_(2)),and at the end of surgery(T_(3)).Stress indicators and inflammatory factor levels were compared 1 hour before and 1 hour after surgery,as well as pain scores at 1 hour,3 hours,and 6 hours after surgery,and the incidence of complications.Results At T_(0),the mean arterial pressure and heart rate of the two groups were basically consistent,with no statistically significant difference(P>0.05).At T_(1)~T_(3),the mean arterial pressure and heart rate of the study group were higher than those of the control group,with statistically significant differences(P<0.05).During T_(0)~T_(3),the mean arterial pressure and heart rate of both groups were within the normal range,and there was no statistically significant difference in the abnormal rate between the two groups(P>0.05).One hour before surgery,the levels of norepinephrine(NE)and cortisol(COR)in the two groups were basically consistent,with no statistically significant difference(P>0.05).One hour after surgery,the levels of NE and COR in the study group were lower than those in the control group,with statistically significant differences(P<0.05).The abnormal rates of NE and COR in the study group were lower than those in the control group 1 hour after surgery,with statistically significant differences(P<0.05).At 1 hour,3 hours,and 6 hours after surgery,the pain scores of the study group were lower than those of the control group,with statistically significant differences(P<0.05).One

关 键 词：胸腔镜 肺叶切除术 艾司氯胺酮 复合麻醉 血流动力学 疼痛 

分 类 号：R734.2[医药卫生—肿瘤]