2018 年第 9 期 第 13 卷

舒芬太尼复合苯磺顺阿曲库铵在肺癌术中麻醉的效果

Anesthetic effect of sufentanil plus cisatracurium besilate on patients undergoing lung cancer surgery

作者：朱毅郑李娜武毅彬

英文作者：

单位：030012太原，山西省肿瘤医院麻醉科

英文单位：

关键词：肺肿瘤；舒芬太尼；苯磺顺阿曲库铵；血管紧张素Ⅱ；皮质醇；丙二醛

英文关键词：

• 摘要：

• 【摘要】目的    探讨舒芬太尼复合苯磺顺阿曲库铵在肺癌术中麻醉的效果。方法    选取2016年3月至2017年6月在山西省肿瘤医院接受手术治疗的90例肺癌患者作为研究对象。根据随机数字表法分为对照组和观察组，各45例。对照组患者采用丙泊酚、依托咪酯及芬太尼静脉全身麻醉；观察组患者采用咪达唑仑、丙泊酚、舒芬太尼复合苯磺顺阿曲库铵麻醉。比较2组患者术后1、48 h血清血管紧张素Ⅱ(Ang-Ⅱ)、皮质醇及丙二醛水平和并发症发生情况。比较2组Ramsay镇静评分及警觉/镇静观察评分法（OAA/S）评分。结果    观察组患者术后1、48 h血清Ang-Ⅱ、皮质醇、丙二醛水平均明显低于对照组［Ang-Ⅱ：（34±3）ng/L比（65±4）ng/L、（35±4）ng/L比（64±4）ng/L；皮质醇：（139±19）μg/L比（238±25）μg/L、（139±16）μg/L比（237±31）μg/L；丙二醛：（0.13±0.04）μg/L比（0.32±0.08）μg/L、（0.14±0.07）μg/L比（0.34±0.08）μg/L］，差异均有统计学意义（均P＜0.001）。观察组患者术后躁动1例、恶心呕吐2例、低氧血症1例，并发症发生率为8.9%（4/45）；对照组患者术后躁动3例、恶心呕吐7例、低氧血症4例，并发症发生率为31.1%（14/45）。观察组并发症发生率明显低于对照组，差异有统计学意义(P＜0.001)。观察组患者Ramsay镇静评分、OAA/S评分均明显高于对照组［（3.11±0.13）分比（1.35±0.12）分、（5.14±0.22）分比（3.02±0.43）分］，差异均有统计学意义（均P＜0.001）。结论    舒芬太尼复合苯磺顺阿曲库铵在肺癌术中麻醉效果显著，能有效降低患者血清Ang-Ⅱ、皮质醇及丙二醛水平，减轻应激反应，利于患者术后恢复。

• 【Abstract】Objective    To analyze the anesthetic effect of sufentanil plus cisatracurium besilate on patients undergoing lung cancer surgery. Methods    Ninety patients undergoing lung cancer surgery from March 2016 to June 2017 in Shanxi Provincial Cancer Hospital were randomly divided into control group and observation group, with 45 cases in each group. Patients in the control group had intravenous general anesthesia with propofol, etomidate and fentanyl; the observation group had midazolam, propofol, sufentanil plus cisatracurium besilate anesthesia. Serum levels of angiotensin Ⅱ(Ang-Ⅱ), cortisol and malondialdehyde were tested 1, 48 h after surgery. Occurrence of complications was observed. Ramsay sedation score and Observer′s Assessment of Alertness/Sedation（OAA/S） score were assessed. Results    Serum levels of Ang-Ⅱ, cortisol （Cor）and malondialdehyde(MDA) at 1, 48 h after surgery in the observation group were significantly lower than those in the control group［Ang-Ⅱ：（34±3）ng/L vs （65±4）ng/L,（35±4）ng/L vs （64±4）ng/L； Cor：（139±19）μg/L vs （238±25）μg/L,（139±16）μg/L vs （237±31）μg/L； MDA：（0.13±0.04）μg/L vs （0.32±0.08）μg/L,（0.14±0.07）μg/L vs （0.34±0.08）μg/L］(P＜0.05). Incidence of postoperative complications in the observation group(1 agitation, 2 nausea and vomiting, 1 hypoxemia) was significantly lower than that in the control group(3 agitation, 7 nausea and vomiting, 4 hypoxemia)［8.9%(4/45) vs 31.1%(14/45)］(P＜0.05). Ramsay sedation score and OAA/S score in the observation group were significantly higher than those in the control group［（3.11±0.13） vs （1.35±0.12）,（5.14±0.22） vs （3.02±0.43）］(P＜0.05). Conclusion    Sufentanil plus cisatracurium besilate has a good anesthetic effect on patients with lung cancer surgery; serum levels of Ang-Ⅱ, cortisol and malondialdehyde can be significantly lowered and stress response can be relieved.