小剂量氯胺酮麻醉对感染性休克病人C反应蛋白的影响

The impact of low-dose ketamine anesthesia on C-reactive protein in patients with septic shhok

目的探讨小剂量氯胺酮麻醉对感染性休克病人C反应蛋白的影响。方法选择我科2008年10月至2011年1月期间收治感染性休克患者30例，随机分为观察组与对照组，观察组给予氯胺酮麻醉，对照组以依托咪酯，维库溴铵和芬太尼等全身麻醉，每组15例，分别于麻醉诱导前（T1）、术后1h（T2）及术后24h（T3）共3个时间点取动脉血，检测C反应蛋白水平。结果观察组与对照组比较，T2和T3时CRP的含量比较差异有统计学意义，P〈0．05；观察组T2、T3与T1比较、T3与T2比较。差异均具有统计学意义，P〈0．05。结论氯胺酮是一种常用的静脉麻醉药．小剂量氯胺酮除了具有麻醉、镇痛作用外，还具有明显的抗炎作用，能有效降低C反应蛋白水平，对感染性休克具有保护作用。

Objective To investigate low-dose ketamine anesthesia on C-reactive protein （ CRP ） in patients with septic shock. Methods 30 patients with septic shock who had been hospitalized during the period of October 2008 to January 2011 were randomly assigned to receive ketamine anesthesia （ 15 patients, study group ）or general anesthesia with etomidate, veeuronium, and fentanyl （ 15 patients, control group ）. Blood CRP levels were detected before induction of anesthesia （ T1 ）, lh ＇after surgery （ T2 ）, and 24h after surgery （ T3 ）. Results There was a significant difference in CRP levels between the two groups at T2 and T3 （ P〈 0.05 ）. There were significant differences in CRP levels between T2 and T1. T3 and T1, and T3 and T2 （ P 〈 0.05 ）. Conclusions Ketamine is a common intravenous anesthetic： agent. Small-dose ketamine not only has an analgesic effect, hut also has a significant anti-inflammatory effect, effectively reducing CRP levels in septic shock.