瑞芬太尼联合不同药物对食管癌根治术患者炎症反应及肺功能影响.docVIP

瑞芬太尼联合不同药物对食管癌根治术患者炎症反应及肺功能影响 　　[摘要] 目的 比较瑞芬太尼联合不同药物对食管癌根治术患者术后炎症反应、肺功能的影响。 方法 将2013年9月～2017年10月心胸外科收治的139例接受根治术治疗的食管癌患者分为瑞芬太尼+异丙酚（D组）、瑞芬太尼+七氟醚组（S组），D组72例，S组67例。术后对比两组的麻醉效果、拔管与苏醒时间、镇静评分、肺功能与炎症反应情况。结果 D组的麻醉效果较好、拔管时间与苏醒时间较短，镇静评分及炎症因子水平较低，且肺功能较好，各项指标与S组对比差异明显。 结论 瑞芬太尼联合异丙酚对食管癌根治术患者的麻醉效果优于瑞芬太尼联合七氟醚，同时能减轻炎症反应，有效保护肺功能，可在临床中推广。 　　[关键词] 肺功能；瑞芬太尼；炎症反应；食管癌根治术；肺功能 　　[中图分类号] R614；R735.1 [文献标识码] B [文章编号] 1673-9701（2018）04-0123-03 　　[Abstract] Objective To compare the effects of remifentanil and different drugs on postoperative inflammatory reaction and pulmonary function in patients with esophageal cancer radical mastectomy. Methods 139 cases of esophageal cancer who underwent radical mastectomy admitted in the Department of Cardiothoracic Surgery from September 2013 to October 2017 were divided into remifentanil+propofol（group D） with 72 cases and remifentanil+sevoflurane（group S） with 67 cases. Postoperative anesthesia effect， extubation and recovery time， sedation score， lung function and inflammatory reaction were compared between the two groups. Results The anesthesia effect in group D was better， and the extubation time and recovery time was shorter. The sedation score and inflammatory cytokine in the group D was lower， and the pulmonary function was better. There was significant difference in each index between group D and group S. Conclusion The anesthesia effect of remifentanil combined with propofol is superior to that of remifentanil combined with sevoflurane in esophageal cancer radical mastectomy for the treatment of radical resection of esophageal cancer. And remifentanil combined with propofol can also reduce the inflammatory reaction and effectively protect the lung function， which is worthy of promotion. 　　[Key words] Pulmonary function； Remifentanil； Inflammatory reaction； Esophageal cancer radical mastectomy； Pulmonary function 　　食管癌根治?g创伤性大，全麻状态下体位改变、双腔导管留置与单肺通气可改变通气血流、肺内分流比例、肺血管的通透性，破坏肺组织、肺泡细胞与气血屏障功能的完整性，引起应激反应，释放促炎因子，再加上患者常合并肺气肿、机体内环境处于紊乱状态，体内皮质醇、肾上腺