艾司氯胺酮对甲状腺癌患者麻醉效果及应激、炎性反应的影响

The effect of esketamine on anesthesia effect,stress and inflammation responses in patients with thyroid cancer

目的:探讨艾司氯胺酮对甲状腺癌患者麻醉效果及应激、炎性反应的影响。方法:2020年3月-2021年3月收治甲状腺癌患者148例,随机分为两组。对照组接受舒芬太尼诱导;试验组接受艾司氯胺酮诱导。比较两组患者临床效果。结果:两组T4(术后12 h)与T0(麻醉前)时的平均动脉压(MAP)、心率(HR)水平比较,差异无统计学意义(P>0.05);两组T1(麻醉插管时)、T2(手术开始时)、T3(手术结束时)时MAP、HR水平升高,T4(术后12h)时MAP、HR水平下降、并与T0时接近,试验组较对照组变化幅度小,差异有统计学意义(P<0.05)。试验组疼痛评分的综合干预总有效率高于对照组,差异有统计学意义(P<0.05)。试验组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。试验组术后肾上腺素(AD)、白介素-6(IL-6)水平均低于对照组,差异有统计学意义(P<0.05)。结论:艾司氯胺酮可改善甲状腺癌患者的血液动力学指标水平,降低术后疼痛和手术应激炎性反应,不良反应少,麻醉安全有效。

Objective:To explore the effect of esketamine on the anesthesia effect,stress and inflammation responses of patients with thyroid cancer.Methods:From March 2020 to March 2021,148 patients with thyroid cancer were selected,they were randomly divided into the two groups.The control group received sufentanilinduction.The experimental group received esketamineinduction.We compared the clinical effects of the two groups of patients.Results:There was no significant difference in MAP and HR levels at T4(12 h after operation)and T0(before anesthesia)between the two groups(P>0.05).The levels of MAP and HR in the two groups increased at T1(during anesthesia intubation),T2(at the beginning of operation)and T3(at the end of operation),and decreased at T4(12 hours after operation),which was close to that at T0,the change range of the experimental group was smaller than that of the control group,the difference was statistically significant(P<0.05).The total effective rate of comprehensive intervention for pain score in the experimental group was higher than that in the control group,the difference was statistically significant(P<0.05).The incidence of adverse reactions in the experimental group was lower than that in the control group,the difference was statistically significant(P<0.05).The postoperative AD and IL-6 levels of the experimental group were lower than those of the control group,the difference was statistically significant(P<0.05).Conclusion:Esketamine can improve the hemodynamic index level of patients with thyroid cancer,reduce postoperative pain and inflammatory reaction of surgical stress,with few adverse reactions,and the anesthesia is safe and effective.