摘要
目的:分析艾司氯胺酮对腹腔镜结肠癌根治术后患者心肌损伤的影响。方法:选取2022年1月至2024年1月,本院136例行腹腔镜结肠癌根治术的患者,采用随机数字表法分为观察组和对照组,每组各68例。2组均采用常规手术麻醉方案,在此基础上观察组麻醉诱导后静脉注射0.5 mg/kg艾司氯胺酮,并静脉泵注维持0.5 mg/(kg·h)的速率至手术结束。比较2组进入手术室时(T1)、麻醉诱导后5 min(T2)、手术结束时(T3)、术后24 h(T4)的心肌损伤标志物、血流动力学指标和炎症因子水平,术后疼痛水平及心脏不良事件等。结果:T1、T2时2组心肌损伤标志物和炎症因子水平比较差异无统计学意义(P>0.05),T3、T4时观察组血清肌酸激酶同工酶MB、高敏肌钙蛋白I、N末端B型利钠肽前体、白细胞介素-6和肿瘤坏死因子-α水平均低于对照组(P<0.05)。T2、T3、T4时观察组心率和平均动脉压水平均低于对照组(P<0.05)。术后6 h观察组疼痛评分低于对照组(P<0.05)。观察组心肌缺血的发生率低于对照组(P<0.05)。结论:艾司氯胺酮能改善腹腔镜结肠癌根治术后患者心肌损伤标志物水平,改善围手术期血流动力学指标和炎症反应,缓解术后疼痛,减少术后心肌缺血的发生概率。
Objective To analyze the effect of esketamine on myocardial injury in patients after laparoscopic radical resection of colon cancerM.I ethods From January 2022 to January 2024,total 136 patients who underwent laparoscopic radical resection of colon cancer in our hospital were selected and divided into an observation group and a control group by the random number table method,with 68 cases in each group.Both groups adopted the conventional surgical anesthesia plan.On this basis,the observation group was intravenously injected with 0.5 mg/kg esketamine after anesthesia induction,and the rate of o.5 mg/(kg·h)was maintained by intravenous pump injection until the end of the operation.The levels of myocardial injury markers,hemodynamic indexes and inflammatory factors at the time of entering the operating room(T1),5 minutes after anesthesia induction(T2),at the end of the operation(T3),and 24 hours after the operation(T4),the postoperative pain levels and adverse cardiac events were compared between the two groups.Results There were no statistically significant differences in the levels of myocardial injury markers and inflammatory factors between the two groups at T1 and T2(P>0.05).At T3 and T4,the serum levels of creatine kinase isoenzyme MB,high-sensitivity troponin I,N-terminal pro-B-type natriuretic peptide,interleukin-6 and tumor necrosis factor-αin the observation group were lower than those in the control group(P<0.05).At T2,T3 and T4,the heart rate and mean arterial pressure levels in the observation group were lower than those in the control group(P<0.05).The pain score in the observation group was lower than that in the control group 6 hours after the operation(P<0.05).The incidence of myocardial ischemia in the observation group was lower than that in the control group(P<0.05).Conclusio1nEsketamine can enhance the levels of myocardial injury markers in patients after laparoscopic radical resection of colon cancer,improve the perioperative hemodynamics and inflammatory response,relieve postoperative pain,and reduce the probability of postoperative myocardial ischemia.
作者
徐冰月
庄彩霞
田飞
胡继英
XU Bing-yue;ZHUANG Cai-ria;TIAN Fei;HU Ji-ying(Department of Operating Room,Zhengzhou Ninth People's Hopsital,Zhengzhou,Henan 450000;Department of Anesthesiology,Zhengzhou First People's Hospital,Zhengzhou,Henan 450000)
出处
《中国肛肠病杂志》
2025年第6期9-12,共4页
Chinese Journal of Coloproctology
关键词
结肠癌
腹腔镜根治术
艾司氯胺酮
心肌损伤
Colon cancer
Laparoscopic radical resection
Esketamine
Myocardial injury
