瑞芬太尼复合丙泊酚麻醉在颈淋巴结结核手术中的效果

Effect of Remifentanil Combined with Propofol Anesthesia in Cervical Lymph Node Tuberculosis Surgery

目的:分析瑞芬太尼复合丙泊酚麻醉在颈淋巴结结核手术中的应用效果。方法:选择2021年11月—2022年11月于南京市中西医结合医院接受手术治疗的颈淋巴结结核患者94例为研究对象,采用随机数字表法将其分为对照组与研究组,各47例。对照组接受氯胺酮复合丙泊酚麻醉,研究组接受瑞芬太尼复合丙泊酚麻醉。比较两组进入手术室时(T1)、诱导后(T2)、切皮时(T3)、清理病灶(T4)、术毕(T5)的收缩压(SBP)、舒张压(DBP)、心率(HR)及脉搏血氧饱和度(SpO2)、苏醒时间、术后15 min Aldrete评分、麻醉相关不良反应。结果:T_(1)~T_(5),研究组各项生命体征比较,差异无统计学意义(P>0.05);T_(1)~T_(5),对照组SpO2水平比较,差异无统计学意义(P>0.05);T_(2)~T_(5),对照组HR、SBP、DBP高于T1,差异有统计学意义(P<0.05);T_(2)~T_(5),对照组HR、SBP、DBP高于研究组,差异有统计学意义(P<0.05);研究组苏醒时间短于对照组,术后15 min的Aldrete评分高于对照组,差异有统计学意义(P<0.001);研究组麻醉相关不良反应发生率低于对照组,差异有统计学意义(P=0.037)。结论:在颈淋巴结结核手术中,采用瑞芬太尼复合丙泊酚麻醉效果较好,患者的血流动力学更为平稳,且术后苏醒较快,安全性较好。

Objective:To analyze the effect of remifentanil combined with propofol anesthesia in cervical lymph node tuberculosis surgery.Methods:Ninety-four patients with cervical lymph node tuberculosis who received surgical treatment in Nanjing Hospital of Integrated Traditional Chinese and Western Medicine from November 2021 to November 2022 were selected as the study ob⁃jects.They were divided into control group and study group with 47 cases in each group by random number table method.The con⁃trol group received ketamine combined with propofol,and the study group received remifentanil combined with propofol.The sys⁃tolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),pulse oxygen saturation(SpO2),recovery time,Aldrete score 15 min after operation and anesthesiation-related adverse reactions were compared between the two groups when entering the operating room(T1),after induction(T2),during skin resection(T3),after lesion cleaning(T4),and after operation(T5).Results:There was no significant difference in vital signs between T1 and T5 groups(P>0.05);There was no significant difference in SpO2 levels between T_(1)-T_(5)and control group(P>0.05);From T2 to T5,HR,SBP and DBP in control group were higher than T1,and the difference was statistically significant(P<0.05);From T2 to T5,HR,SBP and DBP in control group were higher than those in study group,and the difference was statistically significant(P<0.05);The recovery time of the study group was shorter than that of the control group,and the Aldrete score 15 minutes after operation was higher than that of the control group,the difference was statisti⁃cally significant(P<0.001);The incidence of anesthesia related adverse reactions in the study group was lower than that in the con⁃trol group,and the difference was statistically significant(P=0.037).Conclusion:Remifentanil combined with propofol has better anesthetic effect in the operation of cervical lymph node tuberculosis,the hemodynamics of patients are more stable,and the post⁃operative recovery is faster,and the safety is better.