舒芬太尼复合丙泊酚靶控输注在中老年肺尘埃沉着病灌洗术患者中的应用效果

Application effect of target controlled infusion of Sufentanil combined with Propofol on serum cortisol level in middle-aged elderly patients undergoing pneumoconiosis lavage

目的探析舒芬太尼复合丙泊酚靶控输注在中老年肺尘埃沉着病灌洗术患者中的应用效果。方法选取2018年6月至2020年6月江西省胸科医院收治的80例行肺尘埃沉着病灌洗术患者作为研究对象,按照掷硬币法分为对照组(40例)与观察组(40例)。两组均采用靶控输注方式,对照组给予瑞芬太尼+丙泊酚,观察组给予舒芬太尼+丙泊酚。比较两组的血糖、血清皮质醇水平、术后拔管时间以及苏醒时间、镇静-躁动评分、平均动脉压及心率。结果两组在术前血清皮质醇水平的比较,差异无统计学意义(P>0.05);观察组手术开始1 h后、术后拔管时皮质醇水平低于对照组,差异有统计学意义(P<0.05)。观察组术后拔管时间、苏醒时间长于对照组,差异有统计学意义(P<0.05);观察组镇静-躁动评分低于对照组,差异有统计学意义(P<0.05);输注后,观察组心率、平均动脉压高于对照组,差异有统计学意义(P<0.05)。观察组术后拔管时血糖低于对照组,差异有统计学意义(P<0.05)。结论舒芬太尼复合丙泊酚靶控输注在中老年肺尘埃沉着病灌洗术患者的应用,可改善血清皮质醇水平,并延长术后拔管时间与苏醒时间,从而减少应激反应。

Objective To explore the application value of Sufentanil combined with Propofol target-controlled infusion in lavage of middle-aged and elderly patients with pneumoconiosis.Methods A total of 80 patients with pneumoconiosis treated by lavage in Jiangxi Chest Hospital from June 2018 to June 2020 were selected as the research objects,and were divided into control group(40 cases)and observation group(40 cases)according to coin toss method.Target-controlled infusion was used in both groups,the control group was given Remifentanil+Propofol,and the observation group was given Sufentanil+Propofol.Blood glucose,serum cortisol levels,postoperative extubation time and recovery time,sedative-agitation score,mean arterial pressure and heart rate were compared between the two groups.Results There was no significant difference in serum cortisol levels between the two groups before surgery(P>0.05).Cortisol level in the observation group was lower than that in the control group 1 h after operation and at postoperative extubation,the differences were statistically significant(P<0.05).The time of extubation and recovery in the observation group were longer than those in the control group,and the differences were statistically significant(P<0.05).The sedative-agitation score of observation group was lower than that of control group,and the difference was statistically significant(P<0.05).After infusion,the heart rate and mean arterial pressure in observation group were higher than those in control group,the differences were statistically significant(P<0.05).Blood glucose in observation group was lower than control group after extubation,the difference was statistically significant(P<0.05).Conclusion The application of Sufentanil combined with Propofol target-controlled infusion in middle-aged and elderly patients with pneumoconiosis after lavage can improve serum cortisol levels and prolong postoperative extubation time and recovery time,thus reducing the stress response.