摘要
目的:探讨不同剂量艾司氯胺酮在甲状腺癌根治术中的应用效果。方法:选取2020年12月—2022年12月福建省立医院收治的190例甲状腺癌根治术患者。根据随机数表法将其分为对照组和观察组,各95例。两组均给予全身麻醉,气管插管平稳后切皮前5 min静注艾司氯胺酮,对照组静注0.25 mg/kg艾司氯胺酮,观察组静注0.50 mg/kg艾司氯胺酮。比较两组术后1个月恢复情况,麻醉前后炎症因子,术前、术后1 d免疫功能指标,术后0 h(清醒后)、2 h、24 h、48 h疼痛程度及时间指标。结果:术后1个月,观察组情绪状态、身体舒适度、自理能力、心理支持、疼痛感受评分均高于对照组,差异有统计学意义(P<0.05)。麻醉后,两组白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)水平均高于麻醉前,但观察组IL-10、IL-6、TNF-α、IL-1β水平均明显低于对照组,差异有统计学意义(P<0.05)。术后1 d,观察组CD8^(+)低于对照组,CD4^(+)、CD4^(+)/CD8^(+)均高于对照组,差异有统计学意义(P<0.05)。术后0 h、2 h、24 h、48 h,观察组视觉模拟评分法(VAS)评分低于对照组,差异有统计学意义(P<0.05)。观察组术后拔管时间、呼之睁眼时间、自主呼吸恢复时间均早于对照组,差异有统计学意义(P<0.05)。结论:0.50 mg/kg艾司氯胺酮在甲状腺癌根治术患者中的麻醉效果更佳,能够减轻机体疼痛、炎症反应,促进恢复。
Objective:To explore the application effect of different doses of Esketamine in radical surgery for thyroid cancer.Method:A total of 190 patients undergoing radical surgery for thyroid cancer admitted to Fujian Provincial Hospital from December 2020 to December 2022 were selected.According to random number table method,they were divided into control group and observation group,95 cases in each group.Both groups were given general anesthesia,and Esketamine was intravenously injected 5 minutes before skin resection after stable tracheal intubation,0.25 mg/kg Esketamine was intravenously injected in the control group,and 0.50 mg/kg Esketamine was intravenously injected in the observation group.The recovery condition 1 months after surgery of the two groups,inflammatory factors before and after anesthesia,immune function indexes before and 1 d after surgery,pain degree 0 h(after waking up),2 h,24 h,48 h after surgery and time indexes were compared between the two groups.Result:The emotional state,physical comfort,self-care ability,psychological support and pain perception scores of the observation group 1 months after surgery were higher than those of the control group,and the differences were statistically significant(P<0.05).After anesthesia,the levels of interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)in both groups were higher than those before anesthesia,but the levels of IL-10,IL-6,TNF-αand IL-1βin the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).At 1 d after surgery,the CD8^(+) in the observation group was lower than that in the control group,while CD4^(+) and CD4^(+)/CD8^(+)were higher than those in the control group,and the differences were statistically significant(P<0.05).At 0 h,2 h,24 h and 48 h after surgery,the visual analogue scale score(VAS)of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05
作者
吴桂熙
WU Guixi(Fujian Provincial Hospital,Fuzhou 350001,China)
出处
《中外医学研究》
2023年第21期26-30,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
不同剂量
艾司氯胺酮
甲状腺癌根治术
麻醉效果
Different doses
Esketamine
Radical surgery for thyroid cancer
Anesthesia effect
