瑞芬太尼复合丙泊酚全凭静脉麻醉在急腹症伴感染性休克患者手术中的效果与安全性研究  

Efficacy and Safety of Remifentanil and Propofol-Based Total Intravenous Anesthesia in Surgery for Acute Abdomen with Infectious Shock Patients

作　　者：胡娟 曹慧娟 李金荣 黎笑微 HU Juan;CAO Huijuan;LI Jinrong;LI Xiaowei(Fujian Xiamen Army 73rd Group Hospital,Xiamen 361000,China)

机构地区：[1]福建省厦门市陆军第七十三集团军医院,福建厦门361000

出　　处：《中华灾害救援医学》2024年第11期1342-1345,共4页Chinese Journal of Disaster Medicine

基　　金：2022年厦门市医疗卫生指导性项目(3502Z20224ZD1238)。

摘　　要：目的探讨对急腹症伴感染性休克患者术中采取瑞芬太尼复合丙泊酚全凭静脉麻醉的效果及安全性。方法回顾性选取2022年1月至2023年12月本院收治的68例急腹症伴感染性休克患者,采取抽签方式随机分为观察组(瑞芬太尼复合丙泊酚全凭静脉麻醉,34例)和对照组(七氟醚复合丙泊酚全凭静脉麻醉,34例)。比较两组患者应激相关指标、生命体征相关指标、麻醉苏醒情况以及术后不良反应发生情况。结果麻醉诱导时,两组患者去甲肾上腺素、肾上腺素、皮质醇水平无明显差异(P>0.05),手术中和完全清醒时,两组患者以上应激相关激素水平均明显升高(P<0.05)。与对照组相比,手术中和完全清醒时观察组患者以上应激相关激素水平均更低(P<0.05)。麻醉诱导时和完全清醒时,两组患者心率、收缩压、舒张压水平无明显差异;手术中,两组患者心率、收缩压、舒张压均明显降低(P<0.001);与对照组相比,手术中观察组患者心率、收缩压、舒张压水平均较高(P<0.001)。与对照组患者相比,观察组患者麻醉后恢复自主呼吸、呼之睁眼、拔管所需时间均较短(P<0.001);观察组患者术中丙泊酚用量较少(P<0.05)。观察组患者术后不良反应发生率比对照组更低(P<0.05)。结论对于急腹症伴感染性休克患者,采取瑞芬太尼复合丙泊酚全凭静脉麻醉有利于减轻机体的应激反应,维持生命体征的平稳,麻醉后苏醒迅速,安全性高。Objective To investigate the efficacy and safety of remifentanil combined with propofol for total intravenous anesthesia in patients with acute abdominal pain and septic shock during surgery.Methods Sixty eight patients with acute abdomen accompanied by septic shock admitted to our hospital from January 2022 to December 2023 were randomly divided into an observation group(remifentanil combined with propofol total intravenous anesthesia,34 cases)and a control group(sevoflurane combined with propofol total intravenous anesthesia,34 cases)by drawing lots.Compare the stress-related indicators,vital sign related indicators,anesthesia recovery status,and incidence of postoperative adverse reactions between two groups of patients.Results During anesthesia induction,there was no significant difference in the levels of norepinephrine,adrenaline,and cortisol between the two groups of patients(P>0.05).During surgery and when fully awake,the levels of stress related hormones in both groups of patients were significantly increased(P<0.05).Compared with the control group,the observation group had lower levels of stress-related hormones during surgery and when fully awake(P<0.05).There was no significant difference in heart rate,systolic blood pressure,and diastolic blood pressure levels between the two groups of patients during anesthesia induction and when fully awake;During the surgery,both groups of patients showed a significant decrease in heart rate,systolic blood pressure,and diastolic blood pressure(P<0.001);Compared with the control group,the observation group had higher average heart rate,systolic blood pressure,and diastolic blood pressure during surgery(P<0.001).Compared with the control group patients,the observation group patients had a shorter time required to recover spontaneous breathing,open their eyes upon exhalation,and extubate after anesthesia(P<0.001);The observation group had a lower dose of propofol during surgery(P<0.05).The incidence of postoperative adverse reactions in the observation group was lowe

关 键 词：急腹症 休克 麻醉药 

分 类 号：R614[医药卫生—麻醉学]