瑞芬太尼联合丙泊酚麻醉对食管癌根治术患者术后清醒和胰岛素抵抗的影响

Influence of remifentanil combined with propofol on sober and insulin resistance in patients after esophagealcancer radical surgery

目的探讨瑞芬太尼联合丙泊酚对食管癌根治术患者术后清醒和胰岛素抵抗的影响。方法63例采用根治性手术的食管癌患者按数字表法随机分为观察组31例和对照组32例。对照组采用芬太尼联合丙泊酚麻醉，观察组采用瑞芬太尼联合丙泊酚麻醉。观察两组患者拔管时的清醒程度。测定胰岛素抵抗。结果观察组患者拔管后5min警影镇静（OAAS）评分为（3．8±1．6）分，优于对照组的（2．9±1．3）分（t=2．4540，P〈0．05）。与术前比较，两组术后胰岛素抵抗均有明显升高（均P〈0．05），且对照组较观察组升高更明显（P〈0．05）。结论瑞芬太尼联合丙泊酚在食管癌根治术中的麻醉可以提高患者术后清醒程度和减少胰岛素抵抗。

Objective To study the effect of remifentanil combined with propofol on sober and insulin resist- ance in patients after esophageal cancer radical surgery. Methods According to the digital table,63 patients with e- sophageal cancer were randomly divided into the control group（ n = 32 cases） and the observation group（ n = 31 ca- ses）. The control group were anesthetized through fentanyl plus propofol, while the observation group were anesthetized through remifentanil plus propofol. The level of consciousness and insulin resistance were analyzed. Results 5rain af- ter extubafion, the OAAS scores of the observation group was （3.8 ± 1.6 ） points, which was better than that of the control group [ （2.9 ±1. 3 ） points ] （ t = 2. 4540, P 〈 0.05 ）. Compared with preoperation, the insulin resistance of the two groups were all increased after operation（ all P 〈 0.05 ）. And the insulin resistance in the control group was higher than that in the observation group （ P 〈 0.0 5 ） . Conclusion Remifentanil combined with propofol can improve thelevel of consciousness and decrease insulin resistance in patients after esophageal cancer radical surgery.