摘要
目的探讨不同浓度七氟烷+瑞芬太尼对老年结直肠癌患者的麻醉效果,及对麻醉恢复、认知功能的影响。方法选择老年结直肠癌患者110例,随机数字法分为甲组、乙组,各55例。甲组采用0.4 MAC七氟烷复合瑞芬太尼麻醉,乙组采用0.6 MAC七氟烷复合瑞芬太尼麻醉。比较两组血流动力学指标、恢复情况、简易智力状态检查量表(MMSE)评分及血清因子水平。结果两组心率(HR)、平均动脉压(MAP)均先升高后下降,麻醉后5 min(T1)甲组HR、MAP水平较乙组明显下降(P<0.05);甲组苏醒、自主呼吸恢复、定向力恢复时间均短于乙组(P<0.05);两组MMSE评分呈先下降后上升趋势,术后1 h、12 h甲组MMSE评分较乙组明显升高(P<0.05);甲组肿瘤坏死因子(TNF-α)、白细胞介素-1β(IL-1β)水平较乙组显著降低(P<0.05)。结论对老年结直肠癌手术患者采用低浓度七氟烷复合瑞芬太尼进行麻醉,效果较为理想,对患者认知功能影响较小,临床应用价值较高。
Objective To explore the anesthesia effect of different concentrations of sevoflurane and remifentanil on elderly colorectal cancer patients,and its impacts on anesthesia recovery and cognitive function.Methods 110 elderly colorectal cancer patients were randomly grouped into group A and group B,with 55 patients in each group.Group A was anesthetized with 0.4MAC sevoflurane combined with remifentanil,while group B was anesthetized with 0.6MAC sevoflurane combined with remifentanil.The hemodynamic indicators,recovery status,MMSE scores,and serum factor levels were compared between the 2 groups.Results The heart rate(HR)and mean arterial pressure(MAP)of both groups first increased and then decreased,and at 5 minutes after anesthesia(T1),the levels of HR and MAP in group A decreased obviously compared to group B(P<0.05);the time of recovery,recovery time of spontaneous breathing,and recovery time of directional ability in group A were obviously shorter than those in group B(P<0.05);the MMSE score of the 2 groups showed a trend of first decreasing and then increasing,and the MMSE score of group A was obviously higher than that of group B at 1 and 12 hours after surgery(P<0.05);the levels of tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)in group A were obviously lower than those in group B(P<0.05).Conclusion Low concentration sevoflurane combined with remifentanil anesthesia is ideal for elderly patients undergoing colorectal cancer surgery,with minimal impact on cognitive function and high clinical application value.
作者
阮雁捷
冯玉
张真
宋琼
RUAN Yanjie;FENG Yu;ZHANG Zhen(Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou,410000)
出处
《实用癌症杂志》
2024年第8期1311-1314,共4页
The Practical Journal of Cancer
关键词
结直肠癌
七氟烷
瑞芬太尼
麻醉恢复
认知功能
Colorectal cancer
Sevoflurane
Remifentanil
Anesthesia recovery
Cognitive function
