不同剂量的艾司氯胺酮用于普外急腹症手术对术后恢复质量的影响  

Influence of Different Doses of Esketamine on Postoperative Recovery Quality in Acute Abdominal Surgery in Department of General Surgery

作　　者：缪倩 张平恒 叶镇远 MIAO Qian;ZHANG Pingheng;YE Zhenyuan(Department of Anesthesiology,Shangrao People's Hospital,Shangrao 334000,China;不详)

机构地区：[1]上饶市人民医院麻醉科,江西上饶334000

出　　处：《中国医学创新》2025年第9期114-119,共6页Medical Innovation of China

基　　金：上饶市科技计划项目(2023CZDX163)。

摘　　要：目的:探究不同剂量的艾司氯胺酮用于普外急腹症手术对术后恢复质量的影响。方法:选取2023年6月—2024年10月上饶市人民医院收治的90例急腹症患者为研究对象,使用随机数字表法分为对照组(n=30)、A组(n=30)和B组(n=30)。麻醉诱导时,A组静注艾司氯胺酮0.3 mg/kg,B组静注艾司氯胺酮0.5 mg/kg,对照组静注等量0.9%氯化钠注射液,麻醉维持时,A组、B组各自持续泵注艾司氯胺酮0.3 mg/(kg·h)、0.5 mg/(kg·h),均持续泵注注射用盐酸瑞芬太尼0.1~0.3μg/(kg·min),间断给予苯磺顺阿曲库铵注射液,对照组泵注丙泊酚4~6 mg/(kg·h)、注射用盐酸瑞芬太尼0.1~0.3μg/(kg·min),间断给予苯磺顺阿曲库铵注射液。比较三组麻醉恢复情况、血流动力学、应激反应、炎症指标、术后24 h时恢复质量、不良反应差异。结果:A组和B组气管导管拔出时间、呼吸恢复时间、睁眼时间、麻醉恢复时间均早于对照组,且A组气管导管拔出时间、呼吸恢复时间、睁眼时间、麻醉恢复时间均早于B组,差异均有统计学意义(P<0.05);三组在T_(1)、T_(2)、T_(3)时HR、MAP均较T_(0)时降低,差异均有统计学意义(P<0.05);A组和B组HR、MAP均高于对照组,且A组HR、MAP均高于B组,差异均有统计学意义(P<0.05);术后1、2 d时,三组NE、Glu水平均较术前上升,B组、A组NE、Glu均低于对照组,且B组NE、Glu均低于A组,差异均有统计学意义(P<0.05);术后1、2 d时,三组CRP、WBC水平均较术前升高,B组、A组CRP、WBC均低于对照组,且B组CRP、WBC均低于A组,差异均有统计学意义(P<0.05);术后24 h时,三组患者QOR-40得分比较差异有统计学意义(P<0.05),且B组、A组QOR-40得分均高于对照组(P<0.05);B组术后眩晕、眼球震颤、术后谵妄发生率均高于A组和对照组,A组、B组术后心动过缓、低血压发生率均低于对照组,差异均有统计学意义(P<0.05)。结论:在普外急腹症手术中,静脉输注艾司氯胺酮能显著缩短�Objective:To investigate the influence of different doses of Esketamine on the quality of postoperative recovery in patients with acute abdominal surgery in department of general surgery.Method:A total of 90 patients with acute abdomen admitted to Shangrao People's Hospital from June 2023 to October 2024 were selected as the research subjects,and they were divided into control group(n=30),group A(n=30)and group B(n=30)by random number table method.During anesthesia induction,group A was intravenously injected with 0.3 mg/kg of Esketamine,group B was intravenously injected with 0.5 mg/kg of Esketamine,and the control group was intravenously injected with the same amount of 0.9%Sodium Chloride Injection.During anesthesia maintenance,group A and group B were continuously pumped with Esketamine at 0.3 mg/(kg·h)and 0.5 mg/(kg·h)respectively,and were continuously pumped with Remifentanil Hydrochloride for Injection at 0.1-0.3μg/(kg·min),and were given intermittently Cisatracurium Besilate Injection,and control group was pumped with Propofol at 4-6 mg/(kg·h)and Remifentanil Hydrochloride for Injection at 0.1-0.3μg/(kg·min),and was intermittently given Cisatracurium Besilate Injection.The differences in anesthesia recovery status,hemodynamics,stress response,inflammatory indicators,recovery quality at 24 hours after surgery and adverse reactions were compared among the three groups.Result:The tracheal catheter extraction time,respiratory recovery time,eye opening time and anesthesia recovery time were earlier in group A and group B than those in control group,and were earlier in group A than those in group B(P<0.05).At T_(1),T_(2),T_(3),the HR and MAP in the three groups were risen compared with those at T_(0)(P<0.05),and the HR and MAP in group A and group B were higher than those in the control group,and HR and MAP were higher in group A than those in group B(P<0.05).At 1 day and 2 days after surgery,the levels of NE and Glu in the three groups were risen compared with those before surgery,and the levels of NE a

关 键 词：艾司氯胺酮 急腹症 手术 恢复质量 

分 类 号：R61[医药卫生—外科学]