摘要
目的探讨七氟烷与丙泊酚联合瑞芬太尼对脊椎骨折患者炎症因子水平及镇痛效果的影响。方法选取我院2018年10月至2020年10月脊柱外科收治的112例脊椎骨折患者作为研究对象,根据不同麻醉方式将其分为对照组和研究组,各56例。对照组给予七氟烷联合瑞芬太尼麻醉,研究组给予丙泊酚联合瑞芬太尼麻醉。比较两组的麻醉应激反应指标水平、麻醉相关指标、血清炎性因子水平、镇痛效果及不良反应发生情况。结果研究组患者不同时间点的MAP、HR、SpO_(2)、NE、E、Col水平比较,差异无统计学意义(P>0.05);对照组患者不同时间点的MAP、HR、NE、E、Col水平比较,差异具有统计学意义(P<0.05)。研究组的恢复自主呼吸时间、拔管时间、苏醒时间、定向力恢复时间及镇痛药追加次数均优于对照组(P<0.05)。术后,两组的IL-6、CRP、VCAM-1、ICAM-1、E-selectin、P-selectin水平均低于术前(P<0.05),但组间比较,差异无统计学意义(P>0.05)。研究组拔管即刻及术后0.5、6、12、24 h的疼痛评分均低于对照组(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论丙泊酚联合瑞芬太尼可有效提高麻醉及镇痛效果,改善患者术后苏醒状态,且对麻醉应激反应指标影响小,安全性高,对保证脊椎骨折患者手术效果及术后恢复均有积极意义。
Objective To investigate the effects of sevoflurane and propofol combined with remifentanil on inflammatory factors levels and analgesic effect in patients with spinal fracture. Methods A total of 112 patients with spinal fractures treated in spinal surgery department of our hospital from October 2018 to October 2020 were selected as the research objects, and the patients were divided into control group and study group according to different anesthesia methods, with56 cases in each group. The control group was given sevoflurane combined with remifentanil anesthesia, and the study group was given propofol combined with remifentanil anesthesia. The levels of anesthesia stress response indexes,anesthesia related indexes, serum inflammatory factors, analgesic effect and adverse reactions were compared between the two groups. Results There were no significant differences in the levels of MAP, HR, SpO_(2), NE, E and Col in the study group at different time points(P>0.05);there were significant differences in the levels of MAP, HR, NE, E and Col in the control group at different time points(P<0.05). The recovery time of spontaneous breathing, extubation time, wake-up time, recovery time of directional force and the number of additional analgesics in the study group were better than those in the control group(P<0.05). After operation, the levels of IL-6, CRP, VCAM-1, ICAM-1, E-selectin and P-selectin in the two groups were lower than those before operation(P<0.05), but there were no significant differences between the two groups(P>0.05). The pain score of the study group at extubation immediately and 0.5, 6, 12 and 24 h after operation was lower than that in the control group(P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05). Conclusion Propofol combined with remifentanil can effectively increase the effect of anesthesia and analgesia, improve the postoperative recovery state of patients, and has little impact on the indicators of anesthetic stress res
作者
吴文斌
王琴
WU Wenbin;WANG Qin(Anesthesiology Department,People's Hospital of Tongchuan,Tongchuan 727000,China;Critical Care Medicine Department,People's Hospital of Tongchuan,Tongchuan 727000,China)
出处
《临床医学研究与实践》
2022年第4期92-95,共4页
Clinical Research and Practice
关键词
七氟烷
丙泊酚
瑞芬太尼
脊椎骨折
炎症因子
sevoflurane
propofol
remifentanil
spinal fracture
inflammatory factor
