丙泊酚联合瑞芬太尼在风湿性心脏病手术中的应用效果分析

Analysis of the Application Effect of Propofol Combined with Remifentanil in Rheumatic Heart Disease Surgery

目的:探讨丙泊酚联合瑞芬太尼在风湿性心脏病手术中的应用效果。方法:选取2021年6月—2022年10月新疆心脑血管病医院收治的风湿性心脏病患者80例作为研究对象,根据随机数字表法分为观察组和对照组,各40例。对照组给予丙泊酚联合舒芬太尼麻醉,观察组给予丙泊酚联合瑞芬太尼麻醉。比较两组患者心率(HR)、平均动脉压(MAP)、脑电双频指数(BIS),清醒时间、拔管时间,肌钙蛋白(cTnI)、心肌酶谱(CK-MB)、丙二醛(MDA)水平,术后并发症发生率。结果:切皮时、拔管时、离开ICU时,观察组HR、MAP、BIS水平均优于对照组,差异有统计学意义(P<0.05);观察组清醒时间、拔管时间均短于对照组,差异有统计学意义(P<0.05);观察组cTnI、MDA及CK-MB水平均优于对照组,差异有统计学意义(P<0.05);观察组术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论:丙泊酚联合瑞芬太尼对风湿性心脏病患者术中麻醉效果显著,能够改善患者临床指标,缩短清醒时间、拔管时间,安全性较高。

Objective:To investigate the application effect of propofol combined with remifentanil in rheumatic heart disease surgery.Methods:Eighty patients with rheumatic heart disease admitted to Xinjiang Cardio Cerebrovascular Disease Hospital from June 2021 to October 2022 were selected as the study subjects,and were divided into the observation group and the control group according to the method of randomized numerical table,each of which consisted of forty cases.The control group was given propofol combined with sufentanil anesthesia,and the observation group was given propofol combined with remifentanil anesthesia.Heart rate(HR),mean arterial pressure(MAP),electroencephalogram dual-frequency index(BIS),awake time,extubation time,troponin(cTnI),cardiac myosin profile(CK-MB),malondialdehyde(MDA)levels,and the incidence of postoperative complications were compared between the two groups.Results:At the time of skin cutting,at the time of extubation,and at the time of leaving the ICU,the HR,MAP,and BIS levels of the observation group were better than those of the control group,and the differences were statistically significant(P<0.05);The awake time and extubation time of the observation group were shorter than that of the control group,and the difference was statistically significant(P<0.05);The cTnI,MDA and CK-MB levels of the observation group were better than those of the control group,and the difference was statistically significant(P<0.05);The total incidence of postoperative complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Propofol combined with remifentanil has a significant effect on intraoperative anesthesia in patients with rheumatic heart disease,which can improve the patients'clinical indexes,shorten the awake time and extubation time,and has higher safety.