摘要
目的观察丙泊酚麻醉在胃癌患者内镜黏膜下剥离术中的安全性和有效性。方法选取胃癌患者共78例,依据麻醉方法不同随机分为对照组(39例)和观察组(39例);对照组采取维库溴铵和芬太尼进行麻醉;观察组在对照组基础上静脉持续泵入丙泊酚;两组均行内镜黏膜下剥离术(ESD)治疗。比较两组手术时间、住院时间以及术中出血量;记录两组1个月随访期间并发症;比较两组术后视觉模拟疼痛评分(VAS)和Ransay评分;检测两组血清高迁移率族蛋白B1(HMGB1)水平。结果对照组并发症发生率为17.95%,观察组并发症发生率为12.82%,比较差异无统计学意义(P>0.05);观察组患者在手术时间、住院时间以及术中出血量方面均明显优于对照组,比较差异有统计学意义(P<0.01);术后6 d,观察组VAS评分明显低于对照组,Ransay评分明显高于对照组(P<0.01);术后1 h和6 h,观察组血清HMGB1水平分别低于对照组,比较差异有统计学意义(P<0.01)。结论在胃癌患者内镜黏膜下剥离术中应用丙泊酚麻醉,具有较好的有效性和安全性,值得临床推广应用。
Objective To observe safety and effectiveness of propofol anesthesia in endoscopic submucosal dissection for gastric cancer. Methods 78 patients with gastric cancer were randomly divided into the control group and the observation group according to different anesthesia methods, and 39 cases in each group. The control group received vecuronium bromide and fenta- nyl anesthesia. Based on the control group, the observation group were given intravenously continuous pumping of propofol. Both groups received endoscopic submucosal dissection（ESD） treatment. Time of operation,hospital stays and intraoperatve blood loss between the 2 groups were compared. Complications during 6-month follow-up of the 2 groups were recorded. Visual analog pain scale（VAS） and scores of Ransay between the 2 groups were compared. Serum level of high mobility group box-1 protein （ HMGB1 ） of the 2 groups were detected. Results Complication incidence of the observation group was 12.82%, which had no statistically significant difference compared with the control group, 17.95% （P 〉 0.05 ）. Time of operation, hospital stays and intr- aoperative blood loss in the observation group were evidently superior to the control group, there had statistically significant differ- ence（P 〈0.01 ）. After 6-day operation,VAS score of the observation group was obviously lower than that of the control group, while scores of Ransay in the observation group was evidently higher than that of the control group（P 〈 0.01 ）. After 1 h and 6h operation,serum level of HMGB1 in the observation group was lower than that of the control group,there had statistically signifi- cant difference（P 〈 0.01 ）. Conclusion Propofol anesthesia in endoscopic submucosal dissection for gastric cancer has good safety and efficacy. And it is worthy of clinic application.
出处
《实用癌症杂志》
2016年第9期1445-1447,1458,共4页
The Practical Journal of Cancer
关键词
丙泊酚
胃癌
内镜黏膜下剥离术
安全性
有效性
Propofol
Gastric cancer
Endoscopic submucosal dissection
Safety
Effectiveness
