超快通道麻醉对胸腔镜手术患者血流动力学与血清干扰素-γ的影响

Effects of ultrafast track anesthesia on hemodynamics and serum interferon-γin patients undergoing video-assisted thoracoscopic surgery

目的探讨超快通道麻醉(UFTA)对胸腔镜手术(VATS)患者血流动力学与血清干扰素-γ的影响。方法将2019年1月至2022年1月青岛市胶州中心医院收治的120例需行VATS治疗的患者纳入本次前瞻性研究,根据麻醉方式不同分为研究组(n=60)和对照组(n=60),对照组患者采用传统静脉复合麻醉,研究组患者采用UFTA,两组患者均接受VATS。比较两组患者的围手术期指标、血流动力学指标和术前术后的血清干扰素-γ水平,并记录两组的并发症发生情况。结果两组的手术时间、术中出血量比较,差异均无统计学意义(P>0.05);研究组术后胸管留置时间、住院时间分别为(3.65±0.28)、(7.05±0.36)d,较对照组[(5.35±0.32)、(9.15±0.40)d]明显缩短,差异均有统计学意义(P<0.05)。研究组在麻醉前(T0)、手术开始时(T1)、术中30 min(T2)及手术结束时(T3)时间点的心率、平均动脉压与对照组相同时间点比较,差异均无统计学意义(P>0.05),且均在正常范围内。研究组并发症发生率为6.67%,较对照组(20.0%)显著降低,差异有统计学意义(P<0.05)。研究组术后7 d的血清干扰素-γ为(5.482±0.512)pg/mL,较对照组[(2.726±0.433)pg/mL]显著上升,差异有统计学意义(P<0.05)。结论UFTA用于VATS不会对患者术中的血流动力学及手术过程产生影响,可明显缩短胸管留置时间和住院时间,降低术后并发症的发生,有利于患者术后的快速康复。

Objective To investigate the effects of ultrafast track anesthesia(UFTA)on hemodynamics and serum interferon-gamma in patients undergoing video-assisted thoracoscopic surgery(VATS).Methods A total of 120 patients who needed VATS treatment in Qingdao Jiaozhou Central Hospital from January 2019 to January 2022 were enrolled in this prospective study.They were divided into study group(n=60)and control group(n=60)according to different ways of anaesthesia.Patients in control group were anesthetized by traditional intravenous anesthesia,while patients in study group were anesthetized by UFTA,patients in the two groups all received VATS.The hemodynamic indexes,perioperative indexes and serum interferon-gamma levels before and after operation were compared,and the incidence of complications of the two groups was also recorded.Results There was no significant difference on operation time and intraoperative blood loss between the two groups(P>0.05),and the postoperative chest tube indwelling time and hospital stay in the study group were(3.65±0.28)and(7.05±0.36)d,which were markedly shorter than those in the control group[(5.35±0.32),(9.15±0.40)d],the differences were statistically significant(P<0.05).There was no significant difference in heart rate,MAP between the study group and the control group before anesthesia(T0),at the beginning of operation(T1),during 30 min(T2)and at the end of operation(T3)at the same time points(P>0.05),and they were all within the normal range.The incidence of complication in the study group was 6.67%,which was remarkably lower than that in the control group(20.0%),the difference was statistically significant(P<0.05).The serum interferon-gamma in the study group was(5.482±0.512)pg/mL at 7 days after operation,which was dramatically higher than that in the control group[(2.726±0.433)pg/mL],the difference was statistically significant(P<0.05).Conclusion The use of UFTA in VATS will not affect the hemodynamics and operation process,but can significantly shorten the indwelling time of chest tube and hospitalization time,reduce the occurrence of postoperative complications,and is beneficial to the rapid recovery of patients after operation.