| 赵嫣红,蒋海卿,许媛媛,乔海珠,杨晓云,韩 松.艾司氯胺酮联合丙泊酚对腹腔镜全子宫切除术患者血清炎症因子和应激反应的影响[J].,2023,(20):3836-3840 |
| 艾司氯胺酮联合丙泊酚对腹腔镜全子宫切除术患者血清炎症因子和应激反应的影响 |
| Effect of Esketamine Combined with Propofol on Serum Inflammatory Factors and Stress Response in Patients Undergoing Laparoscopic Total Hysterectomy |
| 投稿时间：2023-04-28 修订日期：2023-05-23 |
| DOI：10.13241/j.cnki.pmb.2023.20.007 |
| 中文关键词: 艾司氯胺酮 丙泊酚 腹腔镜全子宫切除术 炎症因子 应激反应 |
| 英文关键词: Esketamine Propofol Laparoscopic total hysterectomy Inflammatory factors Stress response |
| 基金项目:上海市科学技术委员会科研计划项目（16ZR1432200） |
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| 中文摘要: |
| 摘要 目的：观察艾司氯胺酮联合丙泊酚对腹腔镜全子宫切除术患者血清炎症因子和应激反应的影响。方法：选择2020年1月-2022年12月期间同济大学附属同济医院收治的行腹腔镜全子宫切除术患者86例。根据计算机随机生成分组，分为对照组（丙泊酚麻醉，43例）和研究组（艾司氯胺酮联合丙泊酚麻醉，43例）。对比两组血流动力学指标、疼痛情况、炎症因子、应激反应指标和不良反应发生率。结果：气管插管（T2）~切皮后30 min（T4）时间点，两组患者心率（HR）、平均动脉压（MAP）先升高，后下降，但研究组均低于对照组同时间点（P<0.05）。研究组术后6 h、术后12 h、术后24 h疼痛视觉模拟量表（VAS）评分均低于对照组（P<0.05）。两组术后24 h血清白介素-6（IL-6）、C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）水平均升高，但研究组均低于对照组（P<0.05）。两组术后24 h血清肾上腺素（AE）、多巴胺（DA）、去甲肾上腺素（NE）水平均升高，但研究组均低于对照组（P<0.05）。两组不良反应发生率对比未见差异（P>0.05）。结论：艾司氯胺酮联合丙泊酚用于腹腔镜全子宫切除术患者，镇痛效果显著，可维持血流动力学平稳，控制炎症因子和应激指标分泌，且安全有效。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the effect of Esketamine combine with propofol on serum inflammatory factors and stress response in patients undergoing laparoscopic total hysterectomy. Methods: 86 patients undergoing laparoscopic total hysterectomy who were admitted to Tongji Hospital affiliated to Tongji University from January 2020 to December 2022. According to Computer randomly generated groups, the patients were divided into control group (propofol anesthesia, 43 cases) and study group(esketamine and propofol anesthesia, 43 cases). The hemodynamic indicators, pain condition, inflammatory factors, stress response indicators and adverse effects between the two groups were compared. Results: Tracheal intubation (T2) ~30 min after skin cutting (T4) time point, the heart rate (HR) and mean arterial pressure (MAP) between the two groups increased first and then decreased, but the study group was lower than that of in the control group at the same time point (P<0.05). The pain visual analog scale (VAS) scores of the study group at 6 h after operation, 12 h after operation and 24 h after operation were lower than that of the control group (P<0.05). The levels of serum interleukin-6(IL-6), C-reactive protein (CRP), and tumor necrosis factor-α (TNF-α) in the two groups were increased at 24 h after operation, but the study group was lower than that of the control group (P<0.05). Serum epinephrine (AE), dopamine (DA), and norepinephrine (NE) levels in the two groups were increased at 24 h after operation, but the study group was lower than that of the control group (P<0.05). There was no difference in the incidence of adverse effects between the two groups (P<0.05). Conclusion: Esketamine combine with propofol is used in patients with laparoscopic total hysterectomy, with significant analgesic effect, which can maintain hemodynamic stability, control the secretion of inflammatory factors and stress indicators, and is safe and effective. |
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