瑞芬太尼对宫颈癌根治术应激反应的影响

Effects of Remifentanyl on stress response in the radical hysterectomy of cervical cancer

目的:研究瑞芬太尼麻醉对宫颈癌根治术应激反应的影响。方法:60例宫颈癌根治术患者,随机分为两组:瑞芬太尼组(R组)30例和芬太尼组(F组)30例。R组:瑞芬太尼1μg/kg,继以0.2μg/(kg·min)静脉泵注。F组:芬太尼3μg/kg,继以0.03μg/(kg·min)静脉泵注。记录术前、术中血压、心率变化,测定麻醉前、切皮后60min、切皮后120min的血清肾上腺素、去甲肾上腺素、皮质醇、胰岛素和血糖水平。结果:两组切皮后60min、120min的血清肾上腺素、去甲肾上腺素、皮质醇水平均高于术前(P<0.05),切皮后60min、切皮后120min的肾上腺素、去甲肾上腺素、皮质醇和血糖水平R组高于F组(P<0.05)。R组血糖浓度在切皮后60min和120min与术前相比无明显变化(P>0.05),F组血糖浓度在切皮后60min和120min与术前比较均明显增高(P<0.05)。结论:瑞芬太尼能够减轻宫颈癌根治术时应激反应所导致的肾上腺素、去甲肾上腺素、皮质醇和血糖水平增高。

Objective：To investigate the effects of Remifentanyl on stress response in the radical hysterectomy of cervical cancer. Methods ：Sixty patients scheduled for the radical hysterectomy of cervical cancer were divided randomly into two groups：Remifentanyl group（ R group） and fentanyl group（ F group）. R group receiving Remifentanyl 1 μg/ kg and with Remifentanyl 0.2p, g/（kg ·min）was used for general anesthesia. F group receiving fentanyl 3μg/ kg and with fentanyl 0.03 μg/（ kg · min） was used for general anesthesia. Blood pressure, heart rate, adrenaline, noradrenaline,eortisol,insulin and blood sugar level at defined time were measured. Results ：60mitt and 120rain after skin incision, the levels of adrenaline, noradrenaline and cortisolin in the blood were higher than those before the operation （P 〈 0.05）. Besides,at the above time points, the contents of adrenaline, noradrenaline, cortisol and blood sugar inthe R group were higher than those in F group（ P 〈 0.05 ）. Blood sugar content did not change significantly 60rain and 120rain after skin incision in R group （ P 〉 0.05 ）, but increased significantly in the F group （ P 〈 0.05 ）. Condu- sion：Remifentanyl could relieve the increase of adrenaline, noradrenaline, cortisol and blood sugar content resulting from stress response in the radical hysterectomy of cervical cancer.