[1]罗章才,钟绍东,陈康福.瑞芬太尼联合丙泊酚靶控输注对超低位直肠癌手术患者术后苏醒时间及并发症的影响[J].医学信息,2021,(24):77.[doi:10.3969/j.issn.1006-1959.2021.24.016]
 LUO Zhang-cai,ZHONG Shao-dong,CHEN Kang-fu.Effect of Remifentanil Combined with Propofol Target-controlled Infusion on Postoperative Recovery Time and Complications in Patients with Ultra-low Rectal Cancer[J].Medical Information,2021,(24):77.[doi:10.3969/j.issn.1006-1959.2021.24.016]
点击复制

瑞芬太尼联合丙泊酚靶控输注对超低位直肠癌手术患者术后苏醒时间及并发症的影响()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
期数:
2021年24期
页码:
77
栏目:
论著
出版日期:
2021-12-15

文章信息/Info

Title:
Effect of Remifentanil Combined with Propofol Target-controlled Infusion on Postoperative Recovery Time and Complications in Patients with Ultra-low Rectal Cancer
文章编号:
1006-1959(2021)24-0077-04
作者:
罗章才钟绍东陈康福
(于都县人民医院麻醉科,江西 于都 342300)
Author(s):
LUO Zhang-caiZHONG Shao-dongCHEN Kang-fu
(Department of Anesthesiology,Yudu County People’s Hospital,Yudu 342300,Jiangxi,China)
关键词:
直肠癌超低位手术瑞芬太尼丙泊酚麻醉苏醒时间认知功能
Keywords:
Rectal cancerUltra-low surgeryRemifentanilPropofolAnesthesia recovery timeCognitive function
分类号:
R735.3+7
DOI:
10.3969/j.issn.1006-1959.2021.24.016
文献标志码:
A
摘要:
目的 探究瑞芬太尼联合丙泊酚靶控输注对超低位直肠癌手术患者术后苏醒时间及并发症的影响。方法 选取2019年7月-2021年7月于都县人民医院收治的62例直肠癌患者,采用随机数字表法分为对照组和观察组,每组31例。所有患者均接受超低位直肠癌手术治疗,对照组采用瑞芬太尼联合丙泊酚静脉持续输注麻醉,观察组采用瑞芬太尼联合丙泊酚靶控输注麻醉。比较两组麻醉优良率、术后恢复时间(呼吸恢复时间、术后苏醒时间、拔管时间)、血流动力学水平[平均动脉压(MAP)、心率(HR)]、认知功能[简易精神状态检查量表(MMSE)评分]及麻醉并发症情况。结果 两组麻醉优良率对比,差异无统计学意义(P>0.05)。观察组呼吸恢复时间、术后苏醒时间、拔管时间均短于对照组,差异有统计学意义(P<0.05)。两组围术期MAP、HR水平对比,差异无统计学意义(P>0.05)。但观察组MAP、HR波动值小于对照组,差异有统计学意义(P<0.05)。术后,两组MMSE评分均有下降,但观察组术后MMSE评分高于对照组,差异有统计学意义(P<0.05)。观察组麻醉并发症发生率低于对照组(9.68% vs 32.26%),差异有统计学意义(P<0.05)。结论 瑞芬太尼联合丙泊酚靶控输注用于超低位直肠癌手术,效果确切,可在保证麻醉效果的同时缩短术后苏醒时间,维持血流动力学稳定,减少认知功能损害,降低并发症风险。
Abstract:
Objective To investigate the effect of remifentanil combined with propofol target controlled infusion on postoperative recovery time and complications in patients with ultra-low rectal cancer.Methods A total of 62 patients with rectal cancer admitted to Yudu County People’s Hospital from July 2019 to July 2021 were selected and randomly divided into control group and observation group, with 31 cases in each group. All patients underwent ultra-low rectal cancer surgery. The control group received remifentanil combined with propofol intravenous continuous infusion anesthesia, and the observation group received remifentanil combined with propofol target controlled infusion anesthesia. The excellent and good rate of anesthesia, postoperative recovery time (respiratory recovery time, postoperative recovery time, extubation time), hemodynamic levels [mean arterial pressure (MAP), heart rate (HR)], cognitive function [mini-mental state examination (MMSE) score] and anesthesia complications were compared between the two groups.Results There was no significant difference in the excellent and good rate of anesthesia between the two groups (P>0.05). The respiratory recovery time, postoperative recovery time and extubation time in the observation group were shorter than those in the control group, and the difference was statistically significant (P<0.05). There was no significant difference in perioperative MAP and HR between the two groups (P>0.05), but the fluctuation values of MAP and HR in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05). After operation, the MMSE scores of the two groups decreased, but the MMSE score of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). The incidence of anesthesia complications in the observation group was lower than that in the control group (9.68% vs 32.26%), and the difference was statistically significant (P<0.05).Conclusion Remifentanil combined with propofol target-controlled infusion for ultra-low rectal cancer surgery is effective, which can shorten the postoperative recovery time, maintain hemodynamic stability, reduce cognitive impairment and reduce the risk of complications while ensuring the anesthetic effect.

参考文献/References:

[1]于明涛,张春英.右美托咪定复合全身麻醉对老年低位直肠癌患者术后血清T淋巴细胞亚群水平的影响[J].国际医药卫生导报,2019,25(22):3684-3686.[2]尹艳丽,武咏.丙泊酚联合瑞芬太尼靶控输注对老年手术患者麻醉苏醒质量的影响[J].世界复合医学,2021,7(7):1-3,7.[3]张乐,王腾琪,孙海滨.椎旁阻滞复合全身麻醉对超低位直肠癌患者的临床效果[J].国际医药卫生导报,2021,27(11):1672-1675.[4]黄小云.瑞芬太尼静脉输注联合丙泊酚靶控输注在小儿短小手术麻醉中的应用效果[J].临床合理用药杂志,2016,9(15):64-66.[5]张凯舰.全麻复合硬膜外麻醉在高龄低位直肠癌患者术中的应用效果[J].现代肿瘤医学,2020,28(21):3797-3801.[6]田道,张盘石,刘艳霞,等.不同剂量瑞芬太尼联合丙泊酚靶控输注对老年全麻患者应激反应和血流动力学的影响研究[J].陕西医学杂志,2020,49(7):827-829,870.[7]Heiser C,FThenakis P,Hapfelmeier A,et al.Drug-induced sleep endoscopy with target-controlled infusion using propofol and monitored depth of sedation to determine treatment strategies in obstructive sleep apnea[J].Sleep & Breathing,2017,21(1):737-744.[8]谢凌燕,郭桂珍,刘晓军.瑞芬太尼联合丙泊酚靶控输注对子宫肌瘤患者腹腔镜手术中血流动力学及术后苏醒时间的影响[J].中国医院用药评价与分析,2018,18(4):501-503.[9]金卫芳,许春梅,訾瑜强,等.丙泊酚靶控输注联合瑞芬太尼诱导对老年及高血压患者的血流动力学和血清炎症因子的影响[J].重庆医学,2018,47(22):2989-2991.[10]邱新民,王敏,李建玲,等.丙泊酚联合瑞芬太尼靶控输注麻醉对腹腔镜胃癌根治术患者免疫功能和炎性因子及预后的影响[J].临床合理用药杂志,2019,12(21):90-92.[11]明文东.全身麻醉复合硬膜外麻醉在中低位直肠癌患者术中的应用效果[J].河南医学研究,2019,28(16):2946-2947.[12]赵力,彭静,周敏,等.全麻复合腰硬联合麻醉对低位直肠癌患者腹腔镜手术后时间及血清免疫球蛋白、C3水平变化的影响[J].广东医学,2019,40(4):526-530.[13]李彦平,龚勇娟.右美托咪定复合全身麻醉在老年低位直肠癌腹腔镜微创直肠全系膜切除术中的应用[J].广西医科大学学报,2019,36(1):58-62.[14]石凌云,王信云.瑞芬太尼复合丙泊酚靶控输注联合术毕切口局部浸润在老年腹腔镜胆囊手术患者中的麻醉效果观察[J].现代实用医学,2016,28(10):1299-1300.[15]曹洁.丙泊酚联合瑞芬太尼靶控输注全凭静脉麻醉患者术中知晓的发生情况[J].黑龙江医药,2018,31(5):1047-1048.[16]陈带运,曾敏华,池滔.靶控输注瑞芬太尼联合丙泊酚在宫腔镜手术中的应用[J].深圳中西医结合杂志,2019,29(6):186-187.[17]李英,刘郁菁.丙泊酚复合瑞芬太尼靶控输注麻醉对老年中低位直肠癌患者手术术后苏醒时间及镇静评分的影响[J].医学理论与实践,2018,31(22):3389-3391.[18]王宁,张珍妮,李雪,等.丙泊酚闭环靶控输注联合伤害敏感指数指导下的瑞芬太尼靶控输注在妇科腹腔镜手术中的应用[J].山西医科大学学报,2016,47(6):574-577.[19]袁美华.丙泊酚靶控输注复合瑞芬太尼麻醉对超低位直肠癌患者术中血流动力学及术后MMSE评分的影响[J].当代医学,2021,27(13):174-176.[20]宋建平,王学军,张培福,等.丙泊酚联合瑞芬太尼靶控输注对患者血流动力学及脑电双频指数的影响[J].中国老年学杂志,2015,35(19):5574-5575.[21]Cascella M,Fusco R,Caliendo D,et al.Anesthetic dreaming, anesthesia awareness and patient satisfaction after deep sedation with propofol target controlled infusion: A prospective cohort study of patients undergoing day case breast surgery[J].Oncotarget,2017,8(45):79248-79256.[22]刘立鹏.丙泊酚靶控输注复合瑞芬太尼麻醉与静吸复合麻醉在超低位直肠癌患者麻醉中的应用效果[J].慢性病学杂志,2021,22(10):1600-1602.

相似文献/References:

[1]王梦荷,闵 利,李亚玲.Roy适应模式对直肠癌Miles术后结肠造口患者适应水平及家庭负担影响的研究[J].医学信息,2018,(09):163.[doi:10.3969/j.issn.1006-1959.2018.09.054]
 WANG Meng-he,MIN Li,LI Ya-ling.Effect of Roy Adaptation Mode on Adaptation Level and Family Burden of Colostomy Patients after Rectal Cancer Miles Operation[J].Medical Information,2018,(24):163.[doi:10.3969/j.issn.1006-1959.2018.09.054]
[2]张淑贞.永久性肠造口患者延续性护理的研究进展[J].医学信息,2018,(11):63.[doi:10.3969/j.issn.1006-1959.2018.11.020]
 ZHANG Shu-zhen.Research Progress of Continuing Nursing for Patients with Permanent Enterostomy[J].Medical Information,2018,(24):63.[doi:10.3969/j.issn.1006-1959.2018.11.020]
[3]蔡 彬,黄 伟,储正达,等.直肠腔内超声与相控阵线圈磁共振在直肠癌术前局部分期中的Meta分析[J].医学信息,2019,(10):70.[doi:10.3969/j.issn.1006-1959.2019.10.024]
 CAI Bin,HUANG Wei,CHU Zheng-da,et al.Meta-analysis of Intra-rectal Ultrasound and Phased-array Magnetic Resonance in the Preoperative Partial Phase of Rectal Cancer[J].Medical Information,2019,(24):70.[doi:10.3969/j.issn.1006-1959.2019.10.024]
[4]刘 峰,吴晓丽,谢建军.腹腔镜直肠癌全系膜切除术对直肠癌患者远期排尿功能的影响[J].医学信息,2020,(04):104.[doi:10.3969/j.issn.1006-1959.2020.04.031]
 LIU Feng,WU Xiao-li,XIE Jian-jun.Effect of Laparoscopic Total Mesorectal Excision on Rectal Cancer Patients with Long-term Urination Function[J].Medical Information,2020,(24):104.[doi:10.3969/j.issn.1006-1959.2020.04.031]
[5]杨建国,陈清伟,李金豆,等.直肠癌新辅助放化疗与手术间隔时间对临床和肿瘤学结局的影响[J].医学信息,2020,(10):90.[doi:10.3969/j.issn.1006-1959.2020.10.024]
 YANG Jian-guo,CHEN Qing-wei,LI Jin-dou,et al.Effects of Neoadjuvant Radiochemotherapy and Operation Interval of Rectal Cancer on Clinical and Oncological Outcomes[J].Medical Information,2020,(24):90.[doi:10.3969/j.issn.1006-1959.2020.10.024]
[6]周 涛.Ⅱ、Ⅲ期直肠癌Ki-67及微卫星不稳定的表达对预后的影响[J].医学信息,2021,(23):66.[doi:10.3969/j.issn.1006-1959.2021.23.018]
 ZHOU Tao.Effect of Ki-67 and Microsatellite Instability on Prognosis in Stage Ⅱ and Ⅲ Rectal Cancer[J].Medical Information,2021,(24):66.[doi:10.3969/j.issn.1006-1959.2021.23.018]
[7]王 辉,刘爱芬.NOTES腹腔镜下直肠癌根治术治疗直肠癌的效果[J].医学信息,2020,(17):95.[doi:10.3969/j.issn.1006-1959.2020.17.027]
 WANG Hui,LIU Ai-fen.The Effect of Laparoscopic Radical Resection of Rectal Cancer in the Treatment of Rectal Cancer by NOTES[J].Medical Information,2020,(24):95.[doi:10.3969/j.issn.1006-1959.2020.17.027]
[8]梁 杨,胡燕华,王 梅,等.直肠癌术后患者性功能障碍的影响因素及护理现状[J].医学信息,2020,(23):52.[doi:10.3969/j.issn.1006-1959.2020.23.016]
 LIANG Yang,HU Yan-hua,WANG Mei,et al.Influencing Factors and Nursing Status of Patients with Sexual Dysfunction After Rectal Cancer Operation[J].Medical Information,2020,(24):52.[doi:10.3969/j.issn.1006-1959.2020.23.016]
[9]刘 俊,严 婷,刘 红,等.2013~2019年广州某院消化系统恶性肿瘤流行病学分析[J].医学信息,2020,(23):137.[doi:10.3969/j.issn.1006-1959.2020.23.040]
 LIU Jun,YAN Ting,LIU Hong,et al.Epidemiological Analysis of Malignant Tumors of the Digestive System in a Hospital in Guangzhou from 2013 to 2019[J].Medical Information,2020,(24):137.[doi:10.3969/j.issn.1006-1959.2020.23.040]
[10]徐跃心,吕文豪,杨长青,等.妊娠合并胃肠道恶性肿瘤3例临床分析[J].医学信息,2021,(03):190.[doi:10.3969/j.issn.1006-1959.2021.03.056]

更新日期/Last Update: 1900-01-01