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目的探讨七氟烷复合舒芬太尼在结直肠癌手术麻醉中的应用效果,并分析其安全性。方法回顾性分析建瓯市中西医结合医院2014年1月—2017年3月收治的行结直肠癌手术治疗患者68例,根据麻醉方式的不同分为观察组和对照组,各34例。患者入院后均给予舒芬太尼等药物常规诱导,观察组患者给予七氟烷吸入,对照组患者则按照8-6-4方案给予丙泊酚泵入维持。比较两组患者诱导前(T_1)、气管插管后(T_2)、切皮时(T_3)、切皮后5 min(T_4)、术毕停药(T_5)、拔管(T_6)时的心率(HR)、平均动脉压(MAP)变化情况。并记录比较两组患者术后苏醒时间、视觉模拟评分法(VAS)评分及steward评分。结果两组患者各时间段HR比较,差异无统计学意义(P>0.05)。两组患者T_1,T_5,T_6时段MAP比较,差异无统计学意义(P>0.05);观察组患者T_2,T_3,T_4时段MAP高于对照组(P<0.05),其中对照组患者T_2、T_4MAP低于T_1,而T_3MAP高于T_1(P<0.05)。观察组患者术后苏醒时间短于对照组,VAS评分低于对照组,steward评分高于对照组(P<0.05)。结论七氟烷复合舒芬太尼应用于结直肠癌手术中可达到较好的麻醉效果,可较好的抑制腹腔手术引起的应激反应,保持较平稳的血流动力学,有助于缩短患者苏醒时间,降低疼痛程度,且安全性更高。
Objective To investigate the effect of sevoflurane combined with sufentanil in surgical anesthesia of colorectal cancer and to analyze its safety. Methods A retrospective analysis of Jianou Integrative Medicine Hospital from January 2014 to March 2017 admitted to colorectal cancer surgery in 68 patients, divided into observation group and control group according to the different ways of anesthesia, each 34 cases. Patients were given conventional induction of sufentanil and other drugs, patients in the observation group were given inhalation of sevoflurane, and patients in the control group were treated with propofol according to 8-6-4 regimen. The heart rate (HR) at pretreatment (T 1), tracheal intubation (T 2), skin incision (T 3), 5 min after skin incision (T 4) (HR), mean arterial pressure (MAP) changes. The recovery time, visual analogue scale (VAS) score and steward score of the two groups were recorded and compared. Results There was no significant difference in HR between two groups in each time period (P> 0.05). There was no significant difference in MAP between T_1, T_5 and T_6 in the two groups (P> 0.05). The MAP of T_2, T_3 and T_4 in the observation group was higher than that in the control group (P <0.05), and T_2, T_4MAP Lower than T_1, and T_3MAP higher than T_1 (P <0.05). The recovery time of observation group was shorter than that of control group, VAS score was lower than that of control group, steward score was higher than that of control group (P <0.05). Conclusion Sevoflurane combined with sufentanil can be used in colorectal cancer surgery to achieve better anesthetic effect, can better inhibit the stress response caused by abdominal surgery, to maintain a relatively stable hemodynamics, help to shorten Patient wake up time, reduce the degree of pain, and more secure.