中国药房2017，Vol.28Issue(15)：2036-2039,4.DOI:10.6039/j.issn.1001-0408.2017.15.06
靶控输注依托咪酯联合瑞芬太尼对老年手术患者机体免疫及应激反应指标的影响
Effects of Target-controlled Infusion of Etomidate Combined with Remifentanil on Immune and Stress Re-sponse Indexes in Elderly Surgery Patients
摘要
Abstract
OBJECTIVE:To investigate the effects of target-controlled infusion of etomidate combined with remifentanil on in-dexes of immune and stress response in elderly surgery patients. METHODS:Totally 60 patients undergoing elective surgery were randomly divided into control group(n=30)and observation group(n=30). Control group was given Propofol injection 1.5-2 mg/kg intravenously. Observation group was given Remifentanil hydrochloride for injection with pump volume of 0.5 μg/(kg·min), and then target controlled infusion of Etomidate injection 0.1-0.3 mg/kg;the dose of etomidate increased by 0.05-0.1 mg/kg accord-ing to physical activity during surgery. Postoperative eye opening time,recovery time of orientation and extubation time were com-pared between 2 groups as well as the levels of immune indexes(CD4+,CD8+,CD4+/CD8+),stress response indexes [serum norepi-nephrine(NE),adrenaline(E)and cortisol(Cor)]. The occurrence of ADR was recorded during surgery. RESULTS:Postopera-tive eye opening time,recovery time of orientation and extubation time in observation group were significantly shorter than control group,with statistical significance(P<0.05). Before surgery,there was no statistical significance in CD4+,CD8+ and CD4+/CD8+between 2 groups(P>0.05). After surgery,CD4+ and CD8+ of 2 groups were significantly higher than before surgery,and the ob-servation group was significantly higher than the control group,CD4+/CD8+ of 2 groups was significantly lower than before,and the observation group was significantly lower than control group,with statistical significance(P<0.05). Before surgery,there was no statistical significance in the levels of NE,E and Cor between 2 groups(P>0.05);after surgery,the levels of NE,E and Cor in 2 groups were significantly higher than before surgery,but the observation group was significantly lower than the control group, with statistical significance(P<0.05). There were no obvious adverse reaction occurred in 2 groups during the surgery. CONCLU-SIONS:The target-controlled infusion of etomidate combined with remifentanil is ideal for perioperative anaesthesia in the elderly patients and effectively improves related immune indexes and stress response indexes with good safety.关键词
靶控输注/依托咪酯/瑞芬太尼/免疫指标/应激反应/老年/手术患者Key words
Target-controlled infusion/Etomidate/Remifentanil/Immunity/Stress response/Elderly/Surgery patient分类
医药卫生引用本文复制引用
柴林,刘智慧,郑智文,解志强,李海燕..靶控输注依托咪酯联合瑞芬太尼对老年手术患者机体免疫及应激反应指标的影响[J].中国药房,2017,28(15):2036-2039,4.基金项目
唐山市科学技术研究与发展指导计划项目(No.12130295b) （No.12130295b）
