| 唐 毅,李玉娟,陈 亚,赵炬仙,汪惠文.丙泊酚联合依托咪酯麻醉诱导对腹腔镜胆囊切除术患者血流动力学、炎性因子和认知功能的影响[J].,2020,(24):4705-4709 |
| 丙泊酚联合依托咪酯麻醉诱导对腹腔镜胆囊切除术患者血流动力学、炎性因子和认知功能的影响 |
| Effects of Propofol Combined with Etomidate on Hemodynamics, Inflammatory Factors and Cognitive Function in Patients Undergoing Laparoscopic Cholecystectomy |
| 投稿时间：2020-03-27 修订日期：2020-04-23 |
| DOI：10.13241/j.cnki.pmb.2020.24.023 |
| 中文关键词: 依托咪酯 丙泊酚 腹腔镜胆囊切除术 血流动力学 炎性因子 认知功能 |
| 英文关键词: Etomidate Propofol Laparoscopic cholecystectomy Hemodynamics Inflammatory factors Cognitive function |
| 基金项目:甘肃省科技厅自然科学基金项目(17JR5RA334) |
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| 中文摘要: |
| 摘要 目的：探讨丙泊酚联合依托咪酯麻醉诱导对腹腔镜胆囊切除术（LC）患者血流动力学、炎性因子和认知功能的影响。方法：选取2018年6月~2019年9月期间我院收治的行LC治疗的患者90例，随机将患者分为对照组（n=45）和研究组（n=45），对照组患者给予丙泊酚麻醉诱导，研究组采用丙泊酚联合依托咪酯麻醉诱导，比较两组围术期指标、血流动力学、炎性因子、认知功能及不良反应发生率。结果：研究组诱导插管时、气腹后5 min、手术结束时的心率（HR）、平均动脉压（MAP）高于对照组（P<0.05）。研究组术后1 d、术后3 d白介素-6（IL-6）、C反应蛋白（CRP）和肿瘤坏死因子-α（TNF-α）均低于对照组（P<0.05）。研究组睁眼时间、拔管时间、定向力恢复时间短于对照组（P<0.05）。两组术前1 h~术后48 h简易智力状态检查表（MMSE）评分呈先下降后升高趋势，但研究组术后2 h、术后24 h、术后48 h MMSE评分高于对照组（P<0.05）。两组患者不良反应总发生率比较无差异（P>0.05）。结论：LC患者给予丙泊酚联合依托咪酯麻醉诱导，可有效减轻血流动力学波动及炎性应激，降低术后认知功能损害，且安全性较好。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of propofol combined with etomidate induction on hemodynamics, inflammatory factors and cognitive function in patients undergoing laparoscopic cholecystectomy (LC). Methods: From June 2018 to September 2019, 90 patients with LC in our hospital were selected. Patients were randomly divided into control group (n=45) and study group (n=45). Patients in control group were induced by propofol. The study group was induced by propofol and etomidate. The perioperative indexes, hemodynamics, inflammatory factors, cognitive function and incidence of adverse reactions were compared. Results: The heart rate (HR) and mean arterial pressure (MAP) in study group were higher than those in control group at the induction intubation time, 5 minutes after pneumoperitoneum and the end of operation time (P<0.05). The levels of interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor-α(TNF-α) in the study group at 1d after operation and 3 d after operation were lower than those in the control group (P<0.05). The eye opening time, extubation time and directional force recovery time in the study group were shorter than those in the control group (P<0.05). The scores of mini-mental state examination (MMSE) in the two groups decreased first and then increased at 1 h before operation~48 h after operation, but the scores of MMSE in the study group at 2 h after operation, 24 h after operation, 48 h after operation were higher than those in the control group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion: Propofol combined with etomidate induction the patients with LC, it can effectively reduce the hemodynamic fluctuation and inflammatory stress, reduce the postoperative cognitive impairment, and which has a good safety. |
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