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超低位直肠癌患者瑞芬太尼复合丙泊酚靶控输注麻醉与静吸复合麻醉效果比较

Efficacy comparison of remifentanil combined with propofol target-controlled infusion anesthesia and combined intravenous-inhalation anesthesia in patients with ultra-low rectal cancer

摘要目的:比较超低位直肠癌患者静吸复合麻醉与瑞芬太尼复合丙泊酚靶控输注麻醉的效果。方法:回顾性分析2020年2月至2022年2月山西省肿瘤医院100例超低位直肠癌患者的临床资料,依据麻醉方法将患者分为瑞芬太尼复合丙泊酚靶控输注麻醉组(靶控输注麻醉组)和静吸复合麻醉组,每组50例。比较两组麻醉效果、呼吸恢复时间、睁眼时间、麻醉恢复时间、血流动力学、镇静程度、精神状态、不良反应发生情况。结果:靶控输注麻醉组麻醉优良率高于静吸复合麻醉组[92%(46/50)比76%(38/50)],两组差异有统计学意义( χ2=4.76, P<0.05);靶控输注麻醉组呼吸恢复时间、睁眼时间、麻醉恢复时间均短于静吸复合麻醉组(均 P<0.05),手术30 min时的平均动脉压低于静吸复合麻醉组( P<0.05);靶控输注麻醉组术后5、15、30 min的Ramsay镇静评分及术后1、3天的简易智能精神状态检查量表评分均高于静吸复合麻醉组(均 P<0.05)。靶控输注麻醉组和静吸复合麻醉组不良反应发生率[6%(3/50)比8%(4/50)]比较,差异无统计学意义( χ2<0.01, P>0.05)。 结论:与静吸复合麻醉相比,超低位直肠癌患者采用瑞芬太尼复合丙泊酚靶控输注麻醉的效果更好。

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abstractsObjective:To compare the efficacy of combined intravenous-inhalation anesthesia and remifentanil combined with propofol target-controlled infusion anesthesia in ultra-low rectal cancer patients.Methods:The clinical data of 100 patients with ultra-low rectal cancer in Shanxi Province Cancer Hospital from February 2020 to February 2022 were retrospectively analyzed, and the patients were divided into remifentanil combined with propofol target-controlled infusion anesthesia group (target-controlled infusion anesthesia group) and combined intravenous-inhalation anesthesia group according to the anesthesia methods, with 50 patients in each group. The anesthesia effects, respiratory recovery time, eye opening time, anesthesia recovery time, hemodynamics, sedation degrees, mental status and adverse reactions were compared between the two groups.Results:The excellent and good anesthesia rate in the target-controlled infusion anesthesia group was higher than that in the combined intravenous-inhalation anesthesia group [92% (46/50) vs. 76% (38/50)], and the difference between the two groups was statistically significant ( χ2 = 4.76, P < 0.05). The respiratory recovery time, eye opening time and anesthesia recovery time in the target-controlled infusion anesthesia group were shorter than those in the combined intravenous-inhalation anesthesia group (all P < 0.05), and the mean arterial pressure at 30 min of surgery was lower than that in the combined intravenous-inhalation anesthesia group ( P < 0.05). The Ramsay sedation score at 5, 15 and 30 minutes after surgery and the mini-mental state examination score at 1 and 3 days after surgery in the target-controlled infusion anesthesia group were higher than those in the combined intravenous-inhalation anesthesia group (all P < 0.05). The difference in the incidence of adverse reactions between the target-controlled infusion anesthesia group and the combined intravenous-inhalation anesthesia group [6% (3/50) vs. 8% (4/50)] was not statistically significant ( χ2 < 0.01, P > 0.05). Conclusions:The efficacy of remifentanil combined with propofol target-controlled infusion anesthesia is better than that of combined intravenous-inhalation anesthesia for patients with ultra-low rectal cancer.

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