术中添加艾司氯胺酮对腹腔镜子宫全切术后患者胃肠功能的影响  

Effects of intraoperative administration of esketamine on gastrointestinal function in patients undergoing laparoscopic total hysterectomy

作　　者：刘敬 封卫卫 任秀朋[1] 刘彩树 Liu Jing;Feng Weiwei;Ren Xiupeng;Liu Caishu(Department of Gynecology,Dingzhou People's Hospital,Dingzhou 073000,China;Department of Anesthesiology,Dingzhou People's Hospital,Dingzhou 073000,China)

机构地区：[1]定州市人民医院妇科,定州073000 [2]定州市人民医院麻醉科,定州073000

出　　处：《中华内分泌外科杂志(中英文)》2025年第1期110-114,共5页Chinese Journal of Endocrine Surgery

基　　金：河北省医学科学研究课题计划资助(20241910)。

摘　　要：目的:探究术中添加艾司氯胺酮对腹腔镜子宫全切术后患者胃肠功能的影响。方法:选择2022年11月至2023年11月定州市人民医院妇科收治的腹腔镜子宫全切术患者150例为研究对象。根据术中是否添加艾司氯胺酮分为观察组(n=75)和对照组(n=75),对照组接受生理盐水静脉泵注治疗,而观察组加入艾司氯胺酮进行静脉泵注。观察两组治疗后的手术相关时程与药物用量指标、HR变化、平均动脉压变化、不同时刻血清I-FABP质量浓度、不同时刻闭合蛋白-1质量浓度、术后胃肠道症状评定量表评分。结果:观察组气腹时长与术中药物用量低于对照组(P<0.01)。两组心率组间、时间点及交互差异均有统计学意义(P<0.001),观察组T2、T3、T4、T5心率均显著低于对照组(P<0.05)。两组平均动脉压变化组间、时间点及交互差异均有统计学意义(P<0.001),观察组T2、T3、T4、T5平均动脉压变化均显著低于对照组(P<0.05)。两组不同时刻血清肠型脂肪酸结合蛋白(I-FABP)质量浓度组间、时间点及交互差异均有统计学意义(P<0.001),观察组气腹中2 h、气腹结束后血清I-FABP质量浓度均显著低于对照组(P<0.05)。两组不同时刻闭合蛋白-1质量浓度组间、时间点及交互差异均有统计学意义(P<0.001),观察组气腹中2 h、气腹结束后闭合蛋白-1质量浓度均显著低于对照组(P<0.05)。观察组胃肠道症状评分低于对照组,首次排气时间、首次排便时间短于对照组(P<0.05)。结论:在腹腔镜子宫全切术中添加艾司氯胺酮,可促进患者术后胃肠功能的恢复,降低胃肠道症状评分,缩短首次排气和排便时间。Objective:To investigate the effects of intraoperative administration of esketamine on gastrointestinal function in patients undergoing laparoscopic total hysterectomy.Methods:A total of 150 patients undergoing laparoscopic total hysterectomy in Dingzhou People’s Hospital from Nov.2022 to Nov.2023 were selected as the study subjects.They were divided into the observation group(n=75)and the control group(n=75)based on whether esketamine was administered intraoperatively.Patients in the control group received intravenous infusion of normal saline,while those in the observation group received intravenous infusion with added esketamine.Surgical-related time courses,drug dosages,changes in heart rate(HR),changes in mean arterial pressure(MAP),serum intestinal fatty acid-binding protein(I-FABP)concentrations at different time points,claudin-1 concentrations at different time points,and postoperative gastrointestinal symptom rating scale scores were observed in both groups.Results:The pneumoperitoneum duration and intraoperative drug dosage were lower in the observation group than in the control group(P<0.01).Statistically significant differences were found between groups,time points,and interactions for HR(P<0.001),with HR at T2,T3,T4,and T5 being significantly lower in the observation group than in the control group(P<0.05).Statistically significant differences were also found between groups,time points,and interactions for MAP changes(P<0.001),with MAP changes at T2,T3,T4,and T5 being significantly lower in the observation group than in the control group(P<0.05).Statistically significant differences were observed between groups,time points,and interactions for serum I-FABP concentrations at different time points(P<0.001),with the serum I-FABP concentrations at 2 hours during pneumoperitoneum and after pneumoperitoneum being significantly lower in the observation group than in the control group(P<0.05).Similarly,statistically significant differences were found between groups,time points,and interactions for claudin-

关 键 词：艾司氯胺酮 腹腔镜子宫全切术 胃肠功能 

分 类 号：R713.42[医药卫生—妇产科学]