环泊酚与丙泊酚麻醉维持在老年腹腔镜结直肠癌根治术患者中的应用比较

Comparison of ciprofol and propofol anesthesia maintenance in elderly patients undergoing laparoscopic radical surgery for colorectal cancer

目的探讨环泊酚与丙泊酚麻醉维持在老年腹腔镜结直肠癌根治术患者中的应用比较。方法共纳入医院收治的80例行腹腔镜结直肠癌根治术老年患者。随机分为观察组和对照组,每组40例。观察组采用环泊酚麻醉维持,对照组采用丙泊酚麻醉维持。比较两组患者不同时间点炎症因子水平、血流动力学指标、MMSE评分及不良反应。结果两组患者T1~T4时点心率(HR)、收缩压(SBP)及舒张压(DBP)均呈下降趋势,T4~T7时点呈上升趋势,组内比较差异有统计学意义(P<0.05)。组间比较,对照组T4、T5、T6及T7时点SBP及HR均高于观察组(P<0.05);观察组麻醉诱导时间、清醒时间、拔管时间均低于对照组(P<0.05);观察组术后24 h白细胞介素-6(IL-6)与肿瘤坏死因子-α(TNF-α)均低于对照组(P<0.05);观察组的并发症发生率为2.50%(1/40),显著低于对照组的25.00%(10/40),差异有统计学意义(P<0.05);两组不同时间点MMSE评分比较差异有统计学意义(P<0.05),观察组D1、D3、D5 MMSE评分均高于对照组(P<0.05)。结论环泊酚麻醉维持在老年腹腔镜结直肠癌根治术患者中的应用效果与丙泊酚比较,可对患者的血流动力学影响更小,降低术后24 h炎性因子水平差值、不良反应发生情况少,同时对患者术后MMSE评分影响小。

Objective To investigate the use of ciprofol versus propofol anesthesia maintenance in elderly patients undergoing laparoscopic radical surgery for colorectal cancer.Methods A total of 80 elderly patients undergoing laparoscopic radical colorectal cancer surgery were included and randomly divided into observation and control groups,with 40 patients in each group.The observation group received ciprofol for anesthesia maintenance,while the control group received propofol.The levels of inflammatory factors,hemodynamic indicators,MMSE scores,and adverse reactions at different time points were compared between the two groups.Results HR,SBP,and DBP in both groups showed a decreasing trend from T1 to T4 and an increasing trend from T4 to T7,with significant differences within the groups(P<0.05).Comparatively,SBP,and HR at T4,T5,T6,and T7 in the control group were higher than those in the observation group(P<0.05).The induction time,awakening time,and extubation time in the observation group were lower than those in the control group(P<0.05).At 24 hours post-surgery,levels of interleukin-6(IL-6)and tumor necrosis factor-alpha(TNF-α)in the observation group were lower than those in the control group(P<0.05).The incidence of complications in the observation group was 2.50%(1/40),significantly lower than 25.00%(10/40)in the control group(P<0.05).MMSE scores at D1,D3,and D5 were higher in the observation group compared to the control group,with significant differences between the groups(P<0.05).Conclusion The ciprofol anesthesia maintenance in elderly patients undergoing laparoscopic radical colorectal cancer surgery has a better effect compared to propofol.It results in less impact on hemodynamics,lower postoperative inflammatory factor levels,fewer adverse reactions,and less impact on postoperative MMSE scores.