首页|丙泊酚联合依托咪酯用于减重手术中对血流动力学及应激反应的影响

丙泊酚联合依托咪酯用于减重手术中对血流动力学及应激反应的影响

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目的 基于血流动力学、应激反应观察减重手术中应用丙泊酚联合依托咪酯的价值。方法 回顾性选取2020年1月至2021年1月山西白求恩医院收治的接受减重手术的患者,根据术中麻醉方案的不同分为试验组(丙泊酚联合依托咪酯)和对照组(丙泊酚)。记录患者的手术时间、苏醒时间、拔管时间、血流动力学指标[心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2)]、应激指标[促肾上腺皮质激素(ACTH)、肾上腺素(ADR)、皮质醇(COR)]、简易智力状态检查量表(MMSE)评分和不良反应。结果 研究共纳入患者80例,试验组47例,对照组33例。两组手术时间、苏醒时间、拔管时间差异无统计学意义(P>0。05)。插管后即刻试验组HR、MAP低于对照组,SpO2高于对照组(P<0。05)。试验组插管后即刻、拔管后5 min血清ACTH、ADR、COR水平低于对照组(P<0。05)。苏醒后10 min试验组MMSE评分高于对照组(P<0。05)。两组不良反应发生率差异无统计学意义(P>0。05)。结论 减重手术中采用丙泊酚联合依托咪酯可减小血流动力学波动、减轻认知功能损害,可减轻应激反应,且未明显增加麻醉不良反应,安全性较好。
Effect of propofol combined with etomidate on hemodynamics and stress response during weight loss surgery
Objective To observe the value of propofol combined with etomidate in bariatric surgery based on hemodynamics and stress response.Methods Patients admitted to Shanxi Bethune Hospital who underwent bariatric surgery from January 2020 to January 2021 were retrospectively selected and divided into an experimental group (propofol combined with etomidate) and a control group (propofol) according to the intraoperative anesthesia regimen.The patient's surgical time,awakening time,extubation time,hemodynamic indicators[heart rate (HR),mean arterial pressure (MAP),blood oxygen saturation (SpO2)],stress indicators[adrenocorticotropic hormone (ACTH),adrenaline (ADR),cortisol (COR)],Mini Mental State Examination (MMSE) score,and adverse reactions were recorded.Results A total of 80 patients were included in the study,among which 47 cases were in the experimental group,and 33 cases were in the control group.There was no statistically significant difference in operation time,awakening time and extubation time between the two groups (P>0.05).Immediately after intubation,HR and MAP of the experimental group were lower than those of the control group,and SpO2 was higher than that of the control group (P<0.05).Serum ACTH,ADR and COR levels in the experimental group were higher than those in the control group immediately after intubation and 5 min after extubation (P<0.05).The MMSE score of the experimental group 10 min after awakening was higher than that of the control group (P<0.05).The difference in the incidence of adverse reactions between the two groups was not statistically significant (P>0.05).Conclusion The use of propofol combined with etomidate in weight loss surgery can reduce hemodynamic fluctuations,alleviate cognitive impairment,alleviate stress reactions,and does not significantly increase anesthesia adverse reactions,which is with good safety.

Weight loss surgeryPropofolEtomidateHemodynamicsStress responseCognitive impairmentAdverse reactions

焦宏伟、冯晓月、马鹏、段应磊、吕志敢

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山西白求恩医院(山西医学科学院)/山西医科大学第三医院/同济山西医院麻醉科,太原030032

山西白求恩医院(山西医学科学院)/山西医科大学第三医院/同济山西医院疼痛科,太原030032

山西白求恩医院(山西医学科学院)/山西医科大学第三医院/同济山西医院甲状腺减重代谢外科,太原 030032

减重手术 丙泊酚 依托咪酯 血流动力学 应激反应 认知功能 不良反应

2024

中国药师
国家药品监督管理局高级研修学院,武汉医药(集团)股份有限公司

中国药师

CSTPCD
影响因子:0.944
ISSN:1008-049X
年,卷(期):2024.28(10)