不同麻醉深度对老年腹腔镜胃癌根治术患者恢复效果的影响  

Influence of different anesthesia depths on recovery effect of elderly patients undergoing laparoscopic radical gastrectomy for gastric cancer

作　　者：张吴辉 董素枝 徐娅娅 张倩 ZHANG Wu-hui;DONG Su-zhi;XU Ya-ya;ZHANG Qian(Department of Anesthesioloy and Perioperative Medicine,Henan Cancer Hospital,Zhengzhou 450004,China;Department of Anesthesiology,Pingdingshan the First Peoples Hospital,Pingdingshan,Henan 467000,China)

机构地区：[1]河南省肿瘤医院麻醉与围术期医学科,郑州450004 [2]平顶山市第一人民医院麻醉科,河南平顶山467000

出　　处：《医药论坛杂志》2025年第5期553-557,共5页Journal of Medical Forum

摘　　要：目的探讨不同麻醉深度对老年腹腔镜胃癌根治术患者恢复效果的影响。方法2021年1月—2022年12月,选取河南省肿瘤医院行老年腹腔镜胃癌根治术患者100例,按照麻醉深度脑电双频谱指数(bispectral index,BIS)分为A组(49例,深麻醉,BIS为40~49)和B组(51例,浅麻醉,BIS为50~59),比较两组手术相关指标、血流动力学指标、炎症反应因子和住院结局。结果与B组比较,A组定向力恢复时间、拔管时间、苏醒时间更长(P<0.05)。整体比较,心率(heart rate,HR)、平均动脉压(mean arterial pressure,MAP)的时间比较,均有统计学意义(P<0.05);LSD-t得出,与T0比较,两组T1、T2、T3时点MAP降低(P<0.05),与B组比较,A组T1、T2、T3、T4时点HR、MAP比较无统计学意义(P>0.05)。整体比较,肿瘤坏死因子-α(tumor necrosis factorα,TNF-α)、白介素-6(interleukinI-6,L-6)的时间、组间、时间与组间比较,均有统计学意义(P<0.05);与术前比较,两组术后3 d、5 d的TNF-α、IL-6升高(P<0.05),但与B组比较,A组术后3 d、5 d的TNF-α、IL-6更低(P<0.05)。与B组的并发症发生率21.57%比较,A组的20.41%无统计学意义(P>0.05)。与B组的非计划再手术率1.96%比较,A组的2.04%无统计学意义(P>0.05)。两组住院期间均无死亡。结论与浅麻醉(BIS为50~59)比较,深麻醉(BIS为40~49)应用于老年腹腔镜胃癌根治术患者,可延长苏醒时间,减轻炎症反应,且不会增加并发症和非计划再手术发生率。Objective Explored the effect of different anesthesia depths on the recovery outcomes of elderly patients undergoing laparoscopic radical gastrectomy for gastric cancer.Methods From January 2021 to December 2022,select Henan Cancer Hospital 100 elderly patients with laparoscopic radical gastrectomy were selected and divided into group A(49 cases under deep anesthesia,BIS was 49-50)and group B(51 cases under light anesthesia,BIS was 50-59)according to the bispectral index(BIS)of anesthesia depth.The operation-related indexes and hemodynamic indexes of the two groups were compared.Results Compared with group B,the recovery time,extubation time and awakening time of group A were shorter(P<0.05).Overall,heart rate(HR)and mean arterial pressure(MAP)were statistically significant(P<0.05).LSD-t showed that compared with TO,the MAP at T1,T2 and T3 in the two groups decreased(P<0.05),while compared with Group B,the HR and MAP at T1,T2,T3 and T4 in Group A had no statistical significance(P>0.05).On the whole,the time of tumor necrosis factorα(TNF-α)and interleukinI-6(L-6),between groups and between groups were statistically significant(P<0.05).The levels of TNF-αand IL-6 in the two groups increased on the 3rd and 5th day after operation(P<0.05),but the levels of TNF-αand IL-6 in group A were lower on the 3rd and 5th day after operation(P<0.05).Compared with 21.57%in group B,20.41%in group A had no statistical significance(P>0.05).Compared with the unplanned reoperation rate of group B(1.96%),the unplanned reoperation rate of group A(2.04%)was not statistically significant(P>0.05).There was no death in both groups during hospitalization.Conclusion Compared with shallow anesthesia(BIS is 50~59),deep anesthesia(BIS is 49~50)can prolong the recovery time and reduce the inflammatory reaction in elderly patients undergoing laparoscopic radical gastrectomy,and not increase the incidence of complications and unplanned reoperation.

关 键 词：麻醉深度 老年腹腔镜胃癌根治术 围手术期 炎症反应 住院结局 

分 类 号：R614[医药卫生—麻醉学]