| 蔡 哲,索良源,王 怡,张维清,黄泽清.丙泊酚靶控输注复合瑞芬太尼对腹腔镜直肠癌根治术患者血流动力学及术后认知功能的影响[J].,2020,(24):4627-4630 |
| 丙泊酚靶控输注复合瑞芬太尼对腹腔镜直肠癌根治术患者血流动力学及术后认知功能的影响 |
| Effects of Target Controlled Infusion of Propofol Combined with Remifentanil on Hemodynamics and Postoperative Cognitive Function in Patients Undergoing Laparoscopic Radical Resection of Rectal Cancer |
| 投稿时间：2020-02-28 修订日期：2020-03-24 |
| DOI：10.13241/j.cnki.pmb.2020.24.006 |
| 中文关键词: 丙泊酚 靶控输注 瑞芬太尼 腹腔镜 直肠癌根治术 血流动力学 认知功能 |
| 英文关键词: Propofol Target controlled infusion Remifentanil Laparoscopic Radical resection of rectal cancer Hemodynamics Cognitive function |
| 基金项目:辽宁省科学技术计划项目（2015228011） |
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| 中文摘要: |
| 摘要 目的：探讨丙泊酚靶控输注复合瑞芬太尼对腹腔镜直肠癌根治术患者血流动力学及术后认知功能的影响。方法：选取2017年4月~2019年4月期间我院收治的行腹腔镜直肠癌根治术患者101例，根据随机数字表法将患者分为对照组（n=50，静吸复合麻醉）和研究组（n=51，丙泊酚靶控输注复合瑞芬太尼麻醉），比较两组围术期指标、血流动力学、术后认知功能及不良反应情况。结果：研究组麻醉诱导时间、拔管时间、清醒时间、自主呼吸恢复时间均较对照组缩短，丙泊酚使用剂量、瑞芬太尼使用剂量均少于对照组（P<0.05）。两组患者麻醉诱导后（T2）~手术结束时（T5）时间点心率(HR)呈先升高再下降的趋势（P<0.05），平均动脉压(MAP)呈持续升高趋势（P<0.05）；研究组T2时间点HR高于对照组，插管即刻（T3）~手术开始时（T4）时间点HR则低于对照组（P<0.05）；研究组T2~T5时间点MAP均高于对照组（P<0.05）。两组拔管时的简易智能精神状态量表（MMSE）评分均降低，但研究组高于对照组（P<0.05）。两组不良反应发生率比较无统计学差异（P>0.05）。结论：腹腔镜直肠癌根治术中使用丙泊酚靶控输注复合瑞芬太尼麻醉，可有效改善围术期指标，减轻血流动力学波动，对患者术后的认知功能影响较轻。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of target controlled infusion of propofol combined with remifentanil on hemodynamics and postoperative cognitive function in patients undergoing laparoscopic radical resection of rectal cancer. Methods: 101 patients who underwent laparoscopic rectal cancer radical operation in our hospital from April 2017 to April 2019 were selected. According to the random number table, the patients were divided into control group (n=50, intravenous and inhalation combined anesthesia) and study group (n=51, propofol target controlled infusion combined with remifentanil anesthesia). The perioperative indexes, hemodynamics, postoperative cognitive function and adverse reactions of the two groups were compared. Results: The induction time, extubation time, awake time and recovery time of spontaneous respiration in the study group were shorter than those in the control group, and the dosage of propofol and remifentanil were lower than those in the control group (P<0.05). After anesthesia induction (T2) to the end of operation (T5), heart rate(HR) in both groups showed a trend of first increase and then decrease (P<0.05). Mean arterial pressure(MAP) showed a trend of increasing continuously (P<0.05). HR at T2 time point in the study group was higher than in the control group. HR at intubation immediate (T3) ~ operation beginning (T4) were lower than that of the control group (P<0.05). MAP at T2~T5 time points in the study group were higher than that in the control group (P<0.05). The MMSE scores of the two groups were decreased, but that in the study group was higher than that 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). Conclusion: The target controlled infusion of propofol combined with remifentanil anesthesia can effectively improve perioperative indexes, reduce hemodynamic fluctuations, have less impact on patients' cognitive function. |
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