舒芬太尼复合丙泊酚靶控输注在腹腔镜肝癌根治术中的应用研究  

Target-controlled infusion of sufentanil combined with propofol in liver cancer patients treated with laparoscopic radical hepatectomy

作　　者：王承军 潘伟 蒋朝阳 谢隆宇 WANG Chengjun;PAN Wei;JIANG Chaoyang(Operating Room Anesthesia Workspace,Lezhi County People’s Hospital,Sichuan,Ziyang 641500,China;不详)

机构地区：[1]四川省乐至县人民医院手术室麻醉科,641500 [2]四川省乐至县人民医院肝胆外科,641500 [3]西部战区总医院放射治疗科

出　　处：《河北医药》2024年第21期3232-3236,3241,共6页Hebei Medical Journal

基　　金：四川省卫生健康委员会医学科技项目(编号:21PJ068)。

摘　　要：目的探讨舒芬太尼复合丙泊酚靶控输注对腹腔镜肝癌根治术患者肝脏缺血-再灌注损伤及神经功能的影响。方法选择2019年1月至2023年9月行腹腔镜肝癌根治术患者66例,随机数字表法分为观察组和对照组,每组33例。观察组给予舒芬太尼复合丙泊酚靶控输注麻醉,对照组给予舒芬太尼恒速注射联合丙泊酚靶控输注麻醉。比较2组不同时点炎性应激反应、氧化应激反应、肝脏缺血-再灌注损伤、神经功能、不良反应发生情况。结果麻醉1 h(T1)、术后24 h(T2)、术后72 h(T3),观察组血清C-反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)低于对照组(P<0.05);丙二醛(MDA)、皮质醇(Cor)低于对照组,超氧化物歧化酶(SOD)高于对照组(P<0.05);丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)低于对照组(P<0.05);神经生长因子(NGF)高于对照组,中枢神经特异性蛋白(S100β)、神经元特异性烯醇化酶(NSE)低于对照组(P<0.05)。观察组总不良反应发生率为12.12%低于对照组的36.36%(χ^(2)=5.280,P<0.05)。结论舒芬太尼复合丙泊酚靶控输注能够缓解腹腔镜肝癌根治术患者肝脏缺血-再灌注损伤及神经功能受损,可能与降低炎性应激与氧化应激反应等因素有关。Objective To study the effect of target-controlled infusion of sufentanil combined with propofol on hepatic ischemia-reperfusion injury and neurological function in liver cancer patients treated with laparoscopic radical hepatectomy.Methods A total of 66 liver cancer patients treated with an elective laparoscopic radical hepatectomy from January 2019 to 2023 September were selected and randomly divided into the observation group(33 cases)and control group(33 cases).Target-controlled infusion of sufentanil combined with propofol,and constant injection of sufentanil combined with target-controlled infusion of propofol were performed in patients of the observation group and control group,respectively.The inflammatory stress reaction,oxidative stress reaction,hepatic ischemia-reperfusion injury,neurological function and adverse events were compared between two groups at different time points.Results At 1 h of anesthesia(T1),24 h of surgery(T2),and 72 h of surgery(T3),C-reactive protein(CRP),interleukin 6(IL-6)and tumor necrosis factor alpha(TNF-α)were significantly lower in the observation group than those of the control group(P<0.05).Malondialdehyde(MDA)and cortisol(Cor)were significantly lower in the observation group than those of the control group,and superoxide dismutase(SOD)was significantly higher(P<0.05).Alanine transaminase(ALT)and aspartate transaminase(AST)were significantly lower in the observation group than those of the control group(P<0.05).Nerve growth factor(NGF)was significantly higher than that of the control group,and S100 calcium-binding protein B(S100β)and neuron-specific enolase(NSE)were significantly lower(P<0.05).The total incidence of adverse events in the observation group was significantly lower than that of the control group(12.12%vs 36.36%,χ^(2)=5.280,P<0.05).Conclusion Target-controlled infusion of sufentanil combined with propofol can alleviate hepatic ischemia-reperfusion injury and neurological impairment in liver cancer patients with laparoscopic radical hepatectomy by inhibiting

关 键 词：肝癌根治术 舒芬太尼 丙泊酚 靶控输注 应激反应 缺血-再灌注损伤 神经功能 

分 类 号：R392.6[医药卫生—免疫学]