摘要
目的:分析丙泊酚联合瑞芬太尼用于胸腰椎骨折手术中的效果。方法:回顾性分析2024年1月至2024年7月期间我院因胸腰椎骨折行手术治疗的93例患者资料,其中接受丙泊酚联合瑞芬太尼麻醉的46例患者为研究组,接受丙泊酚联合舒芬太尼的47例患者为对照组。采用视觉模拟量表(Visual analogue scale,VAS)评估疼痛度,术前、术后1 d采用酶联免疫吸附法检测血清白介素-6(Interleukin-6,IL-6)、IL-4、IL-2、促肾上腺皮质激素(Adrenocorticotrophic hormone,ACTH)以及C反应蛋白(C reactive protein,CRP)水平,采用增强化学发光免疫分析法检测血清皮质醇(Cortisol,Cor)水平。结果:与研究组相比,对照组麻醉药物追加次数明显较多,拔管时间、睁眼时间较长(P<0.05);插管时、手术开始时、术毕的研究组平均动脉压与心率均比对照组低(P<0.05);术后1 d研究组IL-6、Cor、ACTH以及CRP水平比对照组低,IL-4、IL-2比对照组高(P<0.05);两组不良反应状况对比,无显著差异(P>0.05)。结论:丙泊酚联合瑞芬太尼用于胸腰椎骨折手术中,有助于提高麻醉效果,维持血流动力学稳定,保护免疫功能,减轻应激反应。
Objective:To analyze the effect of propofol combined with remifentanil in the surgery of thoracolumbar fractures.Method:Retrospective analysis of the data of 93 patients who underwent surgical treatment for thoracolumbar fractures in our hospital from January 2024 to July 2024.Among them,46 patients who received propofol combined with remifentanil anesthesia were in the study group,and 47 patients who received propofol combined with sufentanil were in the control group.The Visual Analogue Scale(VAS)was used to assess pain levels.Preoperative and postoperative day 1,serum levels of Interleukin-6(IL-6),IL-4,IL-2,Adrenocorticotrophic hormone(ACTH),and C-reactive protein(CRP)were measured using enzyme-linked immunosorbent assay(ELISA).Serum cortisol(Cor)levels were measured using enhanced chemiluminescence immunoassay.Results:Compared with the study group,the control group had significantly more additional anesthetic drug administrations,longer extubation time,and longer eye-opening time(P<0.05).The mean arterial pressure and heart rate in the study group were lower than those in the control group during intubation,at the beginning of surgery,and at the end of surgery(P<0.05);One day after surgery,the levels of IL-6,Cor,ACTH,and CRP in the study group were lower than those in the control group,while the levels of IL-4 and IL-2 were higher than those in the control group(P<0.05).There was no significant difference in the adverse reaction status between the two groups(P>0.05).Conclusion:The use of propofol combined with remifentanil during thoracolumbar fracture surgery can help improve the anesthetic effect,maintain hemodynamic stability,protect immune function,and reduce stress response.
作者
宋利品
王健
朱淑衡
Song Li-pin;Wang Jian;Zhu Shu-heng(Department of Anesthesia,Yichuan People's Hospital,Luoyang 471300,Henan,China;Department of Anesthesia,Pingdingshan Hospital of Traditional Chinese Medicine,Pingdingshan 467000,Henan,China;Department of Anesthesiology,Luoyang Central Hospital,Luoyang 471000,Henan,China)
基金
河南省医学科技攻关联合共建项目(编号:LHGJ20201074)。
