摘要
目的:探讨瑞马唑仑与丙泊酚对乳房切除术患者围手术期免疫功能的影响并进行对比分析,为该类患者围术期麻醉药物的使用方案提供参考。方法:选取2020年2月~2021年2月期间在本院行乳房切除术的76例患者作为研究对象,按照所用麻醉药物分为对照组和观察组。对照组(n=39)接受丙泊酚麻醉,观察组(n=37)接受瑞马唑仑麻醉,比较两组围术期情况、不良反应发生率及免疫功能。结果:两组手术总时长、手术总输液量、手术出血量、苏醒后疼痛评分比较均无统计学差异(P>0.05);观察组麻醉起效时间、意识恢复时间均短于对照组(P<0.05)。两组不良反应发生率比较无统计学差异(P>0.05)。术后24h两组的CD3^(+)、CD4^(+)、NK细胞水平均低于术前,且观察组CD3^(+)、CD4^(+)、NK细胞水平均高于同时间点对照组(P<0.05)。术后48h观察组CD3^(+)、CD4^(+)、NK细胞水平与术前相比无统计学差异(P>0.05);术后48h对照组CD3^(+)、CD4^(+)、NK细胞水平均低于术前和同时间点观察组(P<0.05)。与术前相比,术后24h、术后48h、术后72h两组CD8^(+)细胞水平均无明显变化(P>0.05),且组间差异均不明显(P>0.05)。结论:瑞马唑仑与丙泊酚对乳房切除术患者均能发挥较好的麻醉作用,且具有较高的安全性。与丙泊酚相比,瑞马唑仑起效更快,对患者围手术期免疫功能的抑制作用更低。
Objective:To investigate the effects of remazolam and propofol on perioperative immune function in mastectomy patients and the comparative analysis was carried out,in order to provide references for the use of perioperative anaesthetic drugs in such patients.Methods:A total of 76 patients undergoing mastectomy in our hospital from February 2020 to February 2021 were selected as the research objects and divided into the control group and the observation group according to the anesthetic drugs used.The control group(n=39)received propofol anesthesia,and the observation group(n=37)received remidazolam anesthesia.The perioperative situation,incidence of adverse effects and immune function were compared between the two groups.Results:There were no significant differences in the total operation time,the total amount of transfusion,the amount of bleeding and the pain score after recovery between the two groups(P>0.05).The onset time of anesthesia and recovery time of consciousness in the observation group were shorter than those in the control group(P<0.05).There was no significant difference in the incidence of adverse effects between the two groups(P>0.05).The levels of CD3^(+),CD4^(+),and NK cells in both groups at 24 h after surgery were lower than those before surgery,and the levels of CD3^(+),CD4^(+),and NK cells in the observation group were higher than those in the control group at the same time points(P<0.05).There was no significant difference in the levels of CD3^(+),CD4^(+)and NK cells between the two groups 48 h after operation(P>0.05);the levels of CD3^(+),CD4^(+),and NK cells in the control group at 48 h after surgery were lower than those observed before surgery and at the same time points(P<0.05).Compared with before operation,the levels of CD8^(+)cells in the two groups did not change significantly at 24 h,48 h and 72 h after operation(P>0.05),and there was no significant difference between the two groups(P>0.05).Conclusion:Both remazolam and propofol exert a better anaesthetic effect in mastectomy patients and have a high safety profile.Compared with propofol,rimazolam has a faster onset and a lower inhibitory effect on the perioperative immune function of patients.
作者
尚学栋
任小栋
周立君
韩雪萍
Shang Xue-dong;Ren Xiao-dong;Zhou Li-jun;Han Xue-ping(Department of Anesthesiology and Perioperative Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《中国合理用药探索》
2022年第2期94-98,共5页
Chinese Journal of Rational Drug Use
基金
河南省医学教育研究项目(Wjlx2019017)。
