首页|艾司氯胺酮用于腹腔镜全子宫切除术麻醉对患者炎性因子及应激反应影响

艾司氯胺酮用于腹腔镜全子宫切除术麻醉对患者炎性因子及应激反应影响

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目的:探讨艾司氯胺酮在腹腔镜全子宫切除术中的麻醉效果及对患者炎性因子水平与应激反应的影响.方法:将2019年7月-2021年7月本院妇科收治的腹腔镜全子宫切除术患者100例随机分成对照组与观察组各50例,分别予以丙泊酚复合舒芬太尼或丙泊酚联合艾司氯胺酮麻醉诱导,麻醉方法相同,比较两组生命体征、炎性因子水平、应激反应及不良反应(呼吸抑制、恶心呕吐、寒颤、躁动、苏醒延迟).结果:两组插管前即刻、插管后1min、插管后3min的平均动脉压与心率均低于麻醉诱导前但观察组高于对照组,两组术后1d血清白介素-6、肿瘤坏死因子-a水平高于术前但观察组(70.53±10.02 ng/L、11.42±2.97 ng/L)低于对照组(96.24±12.84 ng/L、17.93±4.48 ng/L),两组术后1d的皮质醇、肾上腺素、去甲肾上腺素水平均高于术前但观察组(12.45±1.96μg/dl、40.17±5.93 ng/L、164.73± 41.80 ng/L)低于对照组(16.27±2.11μg/dl、54.16±7.22 ng/L、181.95±50.65 ng/L);不良反应总发生率观察组(10.0%)低于对照组(26.0%)(均P<0.05).结论:艾司氯胺酮在腹腔镜全子宫切除术全身麻醉中效果较好,可减少患者血流动力学波动,降低对炎性因子水平的影响,减轻应激反应,减少不良反应.
Effects of esketamine used for anesthesia during laparoscopic total hysterectomy of patients on their inflammatory factor levels and stress response
Objective:To investigate the effects of esketamine used for anesthesia during laparoscopic total hysterecto-my of patients on their inflammatory factor levels and stress response.Methods:100 patients who wanted laparoscopic total hysterectomy were randomly divided into two groups(50 cases in each group)from July 2019 to July 2021.The patients in the control group received anesthesia induction by propofol combined with fentanyl,while the patients in the observation group consisted of 50 patients received anesthesia induction by propofol combined with esketamine,and the other anesthesia methods of the women in the two groups were the same.The vital signs,the inflammatory factor lev-els,the stress reactions,and the adverse reactions(respiratory depression,nausea and vomiting,chills,restlessness and delayed awakening)of the patients were compared between the two groups.Results:The values of the mean arte-rial pressure and heart rate of the patients in the two groups immediately before intubation,at 1min and 3min after in-tubation were significantly lower than those before anesthesia induction,but which of the patients in the observation group were significantly higher than those of the patients in the control group.The levels of serum interleukin-6 and tumor necrosis factor-α of the patients in the two groups after operation had increased significantly,and which(70.53± 10.02 ng/L and 11.42±2.97 ng/L)of the patients in the observation group were significantly lower than those(96.24± 12.84 ng/L and 17.93±4.48 ng/L)of the patients in the control group.The levels of cortisol,epinephrine and norepi-nephrine of the patients in the two groups after operation had increased significantly,and which(12.45±1.96µg/dl,40.17±5.93 ng/L and 164.73±41.80 ng/L)of the patients in the observation group were significantly lower than those(16.27±2.11 μg/dl,54.16±7.22 ng/L and 181.95±50.65 ng/L)of the patients in the control group.The total incidence of adverse reactions(10.0%)of the patients in the observation group was significantly lower than that(26.0%)of the patients in the control group(P<0.05).Conclusion:Esketamine used for anesthesia during laparo-scopic total hysterectomy of patients has good effectiveness,which can decrease the fluctuation of their haemodynam-ics,reduce the influence on their inflammatory factor levels,alleviate their stress reactions,and reduce their adverse reactions.

Laparoscopic total hysterectomyEsketamineInflammatory factorStress responseAdverse reaction

高振宇、刘金华

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浙江省临海市妇幼保健院(317000)

浙江省台州医院

腹腔镜全子宫切除术 艾司氯胺酮 炎性因子 应激反应 不良反应

2024

中国计划生育学杂志
国家人口计生委科学技术研究所

中国计划生育学杂志

CSTPCD
影响因子:1.759
ISSN:1004-8189
年,卷(期):2024.32(1)
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