摘要
目的观察帕瑞昔布钠对老年结直肠癌根治术患者脑保护的影响。方法选择2015年1月—2017年1月浙江省荣军医院收治的符合结直肠癌根治术手术指征的老年患者72例纳入本研究,随机分为2组,每组36例。麻醉诱导前,观察组静脉注射帕瑞昔布钠0.6 mg/kg,对照组静脉注射等剂量生理盐水,之后2组均静注0.3 mg长托宁、0.05 mg/kg咪达唑仑、3μg/kg芬太尼、1.0~1.5 mg/kg丙泊酚、0.15 mg/kg苯磺酸顺-阿曲库铵行麻醉诱导,术中均泵注4~8 mg/(kg·h)丙泊酚及间断静注0.05 mg芬太尼、5 mg顺式-阿曲库铵维持脑电双频指数(BIS)于40~60之间。记录2组患者入室后、诱导后、气管插管后、手术1 h、手术结束血流动力学指标;并于入室后、手术结束、术后12 h、术后24 h、术后48 h抽取静脉血测定血清S100β蛋白、神经元特异性烯醇化酶(NSE)水平,进行统计学分析;比较2组术中不良反应发生率。结果观察组T_2、T_3时刻MAP及HR水平均低于对照组(P<0.05),且对照组T_2、T_3时刻MAP及HR水平均低于T_0时刻(P<0.05),观察组血流动力学更为平稳;观察组给予帕瑞昔布钠后,T_1、T_2、T_3、T_4时刻血清S100β蛋白、NSE水平均低于对照组(均P<0.05);且2组T_1、T_2、T_3、T_4血清S100β蛋白、NSE水平均高于T_0水平(均P<0.05)。2组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论帕瑞昔布钠对老年结直肠癌根治术患者血流动力学平稳,且脑保护作用佳,临床应用安全。
Objective To observe cerebral protection effect of parecoxib sodium in elderly patients with colon and rectum carcinoma operation. Methods Seventy-two eases of elderly patients with colorectal cancer surgery included in the study were randomly divided into 2 groups,36 eases in each group. The observation group and control group were respectively accepted intravenous injection of parecoxib sodium of 0.6 mg/kg before induction, normal saline after intravenous injec- tion of 0.3 mg Thorning,0.05 mg/kg midazolam, fentanyl 3 g/kg, 1 - 1.5 mg/kg 0. 15 mg/kg propofol, CIS atracurium besylate for induction of anesthesia, intraoperative infusion 4 -8 rag/（ kg·h） propofol and intermittent intravenous fenta- nyl 0.05 mg,5 mg cis-atracurium to maintain BIS in 40 -60. Two groups were recorded after the burglary ,after induction of surgical 1 h after tracheal intubation, the end of surgery, hemodynamic indexes ; and after the burglary, the end of surger- y ,postoperative 12 h, postoperative 24 h, postoperative 48 h venous blood serum S100 protein, neuron specific enolase （NSE） levels were statistically analyzed;the incidence of adverse reactions were compared between the two groups. Re- suits The T2,T3 time MAP and HR level in the observation group were lower than the control group （ P 〈 0.05 ） ,T2,T3 time MAP and HR were lower than those of TO （ P 〈 0.05 ）, the observation group was more stable hemodynamics ; the ob- servation group was given parecoxib sodium, Tl , T2, T3, T4, serum S100 beta protein level of NSE were lower than the con- trol group （ P 〈 0.05 ） ; and the 2 groups of T1, T2, T3 , T4, serum S100 protein, NSE levels were higher than the level of To （P 〈 0.05）. Two groups of patients with adverse reaction rate difference was significant （ P 〉 0.05 ）. Conclusion For elderly colorectal cancer root treatment of patients, Pparecoxib sodium can stable blood flow dynamics, and the brain pro- tection effect is good, safe in clinical application.
作者
潘宠勤
钱向东
王志广
朱丽娜
金海飞
雷龙
PAN Chong-qin(Department of Anesthesiology, the Rongiun Hospital of Zhejiang, Jiaxing, Zhejiang 314000, China)
出处
《中华全科医学》
2017年第9期1521-1523,共3页
Chinese Journal of General Practice
