| 金 曼,张 侃,王君毅,张湲钫,黄小倩.瑞芬太尼复合异丙酚靶控输注对脊柱结核手术患者麻醉效果、血流动力学及应激反应的影响[J].,2020,(24):4752-4755 |
| 瑞芬太尼复合异丙酚靶控输注对脊柱结核手术患者麻醉效果、血流动力学及应激反应的影响 |
| Effects of Target Controlled Infusion of Remifentanil Combined with Propofol on Anesthesia, Hemodynamics and Stress Response in Patients Undergoing Spinal Tuberculosis Surgery |
| 投稿时间：2020-04-23 修订日期：2020-05-18 |
| DOI：10.13241/j.cnki.pmb.2020.24.034 |
| 中文关键词: 血流动力学 靶控输注 瑞芬太尼 脊柱结核 应激反应 异丙酚 |
| 英文关键词: Hemodynamics Target controlled infusion Remifentanil Spinal tuberculosis Stress response Propofol |
| 基金项目:陕西省卫生计生委科研基金项目（2016D1246） |
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| 中文摘要: |
| 摘要 目的：探讨瑞芬太尼复合异丙酚靶控输注对脊柱结核手术患者麻醉效果、血流动力学及应激反应的影响。方法：选取2018年3月15日~2019年12月24日期间我院收治的100例行脊柱结核手术患者，根据随机数字表法将患者分为对照组（n=50）和研究组（n=50），对照组患者给予瑞芬太尼+异丙酚静吸复合麻醉，研究组给予瑞芬太尼+异丙酚靶控输注，比较两组患者麻醉效果、血流动力学、应激反应及不良反应情况。结果：研究组术后2 h 视觉模拟评分（VAS）低于对照组（P<0.05），睁眼时间、睫毛反射时间、术后自主呼吸恢复时间、指令动作恢复时间、拔管时间均短于对照组（P<0.05）。研究组术毕时、拔管时、拔管后5 min平均动脉压（MAP）、心率（HR）高于对照组（P<0.05）。研究组术后1 d、术后3 d血管紧张素 Ⅱ（AngⅡ）、去甲肾上腺素（NE）、醛固酮（ALD）低于对照组（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：脊柱结核手术患者采用瑞芬太尼复合异丙酚靶控输注，麻醉效果确切，可有效减轻血流波动及应激反应，且安全性较好。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of target controlled infusion of remifentanil combined with propofol on anesthesia, hemodynamics and stress response in patients undergoing spinal tuberculosis surgery. Methods: From March 15, 2018 to December 24, 2019, 100 patients with spinal tuberculosis who were admitted to our hospital were selected, they were divided into control group (n=50) and study group (n=50), patients in control group were given remifentanil and propofol combined anesthesia, patients in study group was given remifentanil and propofol target controlled infusion, and the anesthesia effect, blood flow mechanics, stress response and adverse reactions of the two groups were compared. Results: The visual pain simulation score (VAS) of the study group was lower than that of the control group 2 h after operation(P<0.05), and the eye opening time, eyelash reflex time, recovery time of spontaneous respiration after operation, command action recovery time and extubation time were shorter than those of the control group(P<0.05). The mean arterial pressure (MAP) and heart rate (HR) of the study group at the end of operation, extubation time, 5 min after extubation were higher than those of the control group (P<0.05). The angiotensin Ⅱ (Ang Ⅱ), norepinephrine (NE), aldosterone (ALD) of the study group at 1d after operation, 3 d after operation were lower than those of the control group (P<0.05). There was no statistic difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Target controlled infusion of remifentanil combined with propofol has a definite anesthetic effect, and can effectively reduce blood flow fluctuation and stress response, with good safety. |
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