文章摘要
何晓华,李晓滨,杨宜科,吴绪才,肖 莉.丙泊酚联合瑞芬太尼麻醉对直肠癌根治术患者血流动力学和T淋巴细胞亚群的影响[J].,2020,(12):2351-2354
丙泊酚联合瑞芬太尼麻醉对直肠癌根治术患者血流动力学和T淋巴细胞亚群的影响
Effects of Propofol Combined with Remifentanil Anesthesia on Hemodynamics and T Lymphocyte Subsets in Patients Undergoing Radical Resection of Rectal Cancer
投稿时间:2019-10-24  修订日期:2019-11-20
DOI:10.13241/j.cnki.pmb.2020.12.033
中文关键词: 丙泊酚  瑞芬太尼  直肠癌根治术  血流动力学  T淋巴细胞亚群
英文关键词: Propofol  Remifentanil  Radical resection of rectal cancer  Hemodynamics  T lymphocyte subsets
基金项目:广西科技攻关计划基金项目(1512400417)
作者单位E-mail
何晓华 广西医科大学第八附属医院麻醉科 广西 贵港 537120 gxhexiaohua@163.com 
李晓滨 宝鸡市中医医院麻醉科 陕西 宝鸡 721000  
杨宜科 广西中医药大学第一附属医院麻醉科 广西 南宁 530023  
吴绪才 西安交通大学医学院附属红会医院麻醉一科 陕西 西安 710054  
肖 莉 西安交通大学医学院附属红会医院麻醉一科 陕西 西安 710054  
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中文摘要:
      摘要 目的:探讨直肠癌根治术患者采用丙泊酚联合瑞芬太尼麻醉维持的临床效果。方法:选取2016年3月~2019年3月期间在我院行直肠癌根治术的患者82例,根据乱数表法将患者分为对照组(n=41)和研究组(n=41),其中对照组给予七氟醚麻醉维持,研究组给予丙泊酚联合瑞芬太尼麻醉维持,比较两组患者围术期指标、血流动力学和T淋巴细胞亚群变化,记录两组围术期不良反应情况。结果:研究组患者的清醒时间、拔管时间均短于对照组(P<0.05)。两组患者麻醉成功后(T2)~术后72 h(T5)时间点心率(HR)、平均动脉压(MAP)均呈先降低后升高趋势(P<0.05);研究组T2~术后24 h(T4)时间点HR、MAP高于对照组(P<0.05)。两组不良反应发生率对比无差异(P>0.05)。两组患者T2~T5时间点CD4+、CD4+/CD8+均呈先降低后升高趋势(P<0.05),CD8+呈先升高后降低趋势(P<0.05);研究组T2~T4时间点CD4+、CD4+/CD8+高于对照组(P<0.05),CD8+低于对照组(P<0.05)。结论:直肠癌根治术患者麻醉维持选用丙泊酚联合瑞芬太尼可减少对机体血流动力学的影响,减轻免疫抑制,改善围术期相关指标,且不增加不良反应发生率。
英文摘要:
      ABSTRACT Objective: To investigate the effects of propofol combined with remifentanil anesthesia on hemodynamics and T lymphocyte subsets in patients undergoing radical resection of rectal cancer. Methods: 82 patients with rectal cancer who underwent radical operation in our hospital from March 2016 to March 2019 were selected, and they were divided into control group (n=41) and study group (n=41) according to random number table method. The control group was given sevoflurane anesthesia for maintenance, and the study group was given propofol combined with remifentanil anesthesia maintenance. Perioperative indexes, hemodynamics and T lymphocyte subsets were compared between the two groups, and adverse reactions during treatment were recorded between the two groups. Results: The awakening time and extubation time of the study group were shorter than those of the control group (P<0.05). Heart rate (HR) and central venous pressure (MAP) decreased first and then increased after successful anesthesia (T2)~72 h after anesthesia (T5) between the two groups (P<0.05). HR and MAP in the study group at T2~24 h after anesthesia (T4) were higher than those in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). The CD4+, CD4+/CD8+ in both groups decreased at first and then increased at T2~T5 time points (P<0.05). CD8+ increased first and then decreased (P<0.05). CD4+, CD4+/CD8+ in the study group at T2~T4 time points were higher than those in the control group (P<0.05), and CD8+ was lower than that in the control group (P<0.05). Conclusion: Propofol combined with remifentanil anesthesia can reduce the hemodynamic effects, alleviate immune suppression, improve perioperative related indicators, and do not increase the incidence of adverse reactions in patients undergoing radical resection of rectal cancer.
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