摘要
目的探讨晚期恶性肿瘤患者采用经皮射频消融术治疗时瑞芬太尼靶控输注的临床效果及安全性。方法选取2012年1月至2014年10月间收治的73例拟行射频消融术治疗的晚期恶性肿瘤患者,采用随机数字表法将其分为研究组(37例)和对照组(36例)。研究组患者采用瑞芬太尼靶控输注全身麻醉,对照组患者采用气管内插管全身麻醉。比较两组患者术前(T0)、进针即刻(T1)、治疗5 min(T2)、治疗10 min(T3)、手术完成即刻(T4)的心率(HR)、平均动脉压(MAP)、血氧饱和度(Sp O2)的监测值;比较两组患者的手术时间、苏醒时间、离室时间、术后疼痛评分及不良反应发生率的差异。结果 T0时刻两组患者的MAP、HR和Sp O2差异均无统计学意义(均P>0.05);两组患者T1、T2、T3时刻的MAP、HR和Sp O2与T0时刻比较,差异均有统计学意义(均P<0.05);在T1、T2、T3时刻,研究组患者的MAP、HR、Sp O2与对照组比较,差异均有统计学意义(均P<0.05)。研究组患者的手术时间[(34.5±4.2)min]、苏醒时间(0 min)、离室时间[(8.1±3.5)min]均显著短于对照组(均P<0.05),疼痛视觉评分(VAS)显著高于对照组(P<0.05)。研究组患者的不良反应发生率为16.2%(6/37),显著低于对照组的41.7%(15/36),差异有统计学意义(P<0.05)。结论晚期肿瘤患者采用经皮射频消融术治疗时瑞芬太尼靶控输注具有较好的麻醉效果,对患者的循环波动影响较小,术后不良反应率低。
Objective To explore the efficacy and safety of remifentanil target controlled infusion anesthesia when percutaneous radiofrequency catheter ablation in the treatment of advanced tumor patients.Methods The 73 patients with advanced tumors in People’s Hospital of Zhanjiang City underwent radiofrequency ablation for the treatment were randomly divided into study group( 37 cases) and control group( 36cases). Patients in the study group received remifentanil target controlled infusion anesthesia,while patients in control group received endotracheal intubation of general anesthesia. Before surgery( T0),time at inserting needle( T1),treatment of 5 min( T2),treatment of 10 min( T3),and time at immediate complete operation( T4),heart rate( HR),mean arterial pressure( MAP),oxygen saturation( Sp O2) monitoring value of two groups were compared. The difference of the operation time,recovery time,the time of recovery,the pain score and the incidence of adverse reactions were compared between the two groups. Results There were no differences in MAP,HR and Sp O2 of T0 moment between two groups( P 〉 0. 05); MAP,HR and Sp O2 of T1,T2,T3 moment in two groups had statistical differences than those of T0 moment( P 〈0. 05). In study group,operation time was( 34. 5 ± 4. 2) min,recovery time was 0 min,Leave room time was( 8. 1 ± 3. 5) min,which were significantly shorter than those of control group( P 〈 0. 05). Visual analog scale( VAS) score of study group was significantly higher than those of the control group( P 〈 0. 05).The incidence of adverse reactions in the study group was 16. 2( 6 /37),which was significantly lower than that of the control group 41. 7%( 15 /36),and the difference was statistically significant( P 〈 0. 05). Conclusions Remifentanil target controlled infusion anesthesia when percutaneous radiofrequency catheter ablation in the treatment of advanced tumor patients has better anesthetic effect,little effect on the patient’s circulation fluctuations,and low postoperative adverse reactions.
出处
《中国肿瘤临床与康复》
2016年第4期415-418,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
肿瘤
经皮射频消融术
瑞芬太尼
靶控输注
Neoplasms
Percutaneous radiofrequency catheter ablation
Remifentanil
Target controlled infusion