苯磺酸瑞马唑仑联合艾司氯胺酮对腹腔镜下结直肠癌根治术患者围手术期应激反应的影响  

Effect of Rezolam Benzenyl Combined with Esketamine on Perioperative Stress Response in Patients Undergoing Laparoscopic Radical Colorectal Cancer

作　　者：顾顺 查卫峰 贾银银 GU Shun;ZHA Weifeng;JIA Yinyin(Department of Anesthesiology,Lianshui County People’s Hospital,Huai’an,Jiangsu 223400,China)

机构地区：[1]涟水县人民医院麻醉科,江苏淮安223400

出　　处：《中国医药指南》2025年第8期53-56,共4页Guide of China Medicine

摘　　要：目的分析苯磺酸瑞马唑仑联合艾司氯胺酮对腹腔镜下结直肠癌根治术患者围手术期应激反应的影响。方法选取涟水县人民医院2022年3月至2024年8月收治的93例行腹腔镜下结直肠癌根治术的患者,经随机数字表法将入组患者分为两组,研究组47例,对照组46例。对照组在麻醉诱导时使用苯磺酸瑞马唑仑,研究组在麻醉诱导前静脉滴注艾司氯胺酮,对比两组的苏醒质量指标(自主呼吸恢复时间、定向力恢复时间、呼之睁眼时间)、应激反应指标[皮质醇(Cor)、去甲肾上腺素(NE)及肾上腺素(E)]、免疫功能(CD3^(+)、CD4^(+)、CD8^(+))及睡眠质量[匹兹堡睡眠质量指数(PSQI)]。结果研究组自主呼吸恢复时间、定向力恢复时间、呼之睁眼时间较对照组短(均P<0.05)。研究组Cor、NE、E水平较对照组低(均P<0.05)。术后1 d,研究组CD3^(+)、CD4^(+)、CD8^(+)优于对照组(均P<0.05)。术后1 d,研究组PSQI评分在睡眠效率、睡眠质量、入睡时间、催眠药物、睡眠时间、睡眠障碍、日间功能障碍方面较对照组更低(均P<0.05)。结论苯磺酸瑞马唑仑联合艾司氯胺酮麻醉应用于腹腔镜下结直肠癌根治术患者能够提高患者术后苏醒质量,降低患者应激反应,改善患者免疫功能,从而改善患者术后睡眠质量。Objective To analyze the effects of remazolam besylate combined with esketamine on perioperative stress response in patients undergoing laparoscopic radical resection of colorectal cancer.Methods A total of 93 patients who underwent laparoscopic radical resection of colorectal cancer from March 2022 to August 2024 at Lianshui County People’s Hospital were selected and randomly divided into two groups using a random number table method.The study group included 47 patients,while the control group had 46 patients.In the control group,remimazolam besylate was used during anesthesia induction,whereas in the study group,esketamine was administered intravenously before anesthesia induction.The study compared the two groups in terms of awakening quality indicators[time to spontaneous breathing recovery,time to orientation recovery,and time to eye opening on command],stress response indicators[cortisol(Cor),norepinephrine(NE),and epinephrine(E)],immune function(CD3+,CD4+and CD8+),and sleep quality[Pittsburgh Sleep Quality Index(PSQI)].Results Compared to the control group,the study group had shorter times to spontaneous breathing recovery,orientation recovery,and eye opening on command(all P<0.05).The levels of Cor,NE,and E were lower in the study group than in the control group(all P<0.05).One day after surgery,the levels of CD3^(+),CD4^(+),and CD8^(+)were better in the study group than in the control group(all P<0.05).One day after surgery,The PSQI scores of the study group were lower than those of the control group in terms of sleep efficiency,sleep quality,sleep latency,hypnotic medications,sleep duration,sleep disturbances,and daytime dysfunction.(all P<0.05).Conclusions Remazolam besylate combined with esketamine anesthesia in patients undergoing laparoscopic radical resection of colorectal cancer can improve postoperative recovery quality,reduce stress response,improve immune function,and thus improve postoperative sleep quality.

关 键 词：结直肠癌根治术 苯磺酸瑞马唑仑 艾司氯胺酮 应激反应 苏醒质量 免疫功能 睡眠质量 

分 类 号：R735.3[医药卫生—肿瘤]