2018七氟醚复合舒芬太尼对腰椎内固定术患者围术期炎症因子的影响

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　　[摘要] 目的 探?七氟醚复合舒芬太尼对腰椎内固定术患者围术期血流动力学及炎症因子的影响。 方法 选择择期行腰椎内固定患者80例，随机分为七氟醚组（n=40，以七氟醚吸入麻醉维持）和对照组（n=40，采用丙泊酚静脉麻醉维持），两组麻醉诱导后均采用舒芬太尼静脉推注维持术中镇痛。监测记录麻醉诱导前5 min（T0）、气管插管后即刻（T1）、切皮1 min后（T2）、拔除气管导管前即刻（T3）血流动力学指标。抽取 T0、T3、术后 8 h（T4）、术后24 h（T5）外周静脉血，采用 ELISA 法测定C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）水平。结果 两组患者的麻醉诱导时间、手术时间、术中失血量以及各时间点血流动力学指标均无显著差异。与T0比较，两组CRP、IL-6、TNF-α在T3时间点开始升高，在T4点达到最高（P http://
　　[关键词] 七氟醚；舒芬太尼；腰椎内固定术；炎症因子
　　[中图分类号] R614 [文献标识码] B [文章编号] 1673-9701（2018）03-0107-04
　　Effect of sevoflurane combined with sufentanil on the perioperative inflammatory factors in the patients undergoing lumbar spine internal fixation
　　LIU Xiaoguo XIA Xingui YANG Shizhong CHEN Yanqin
　　Department of Anesthesiology， Zhejiang PAP Corps Jiaxing Hospital， Jiaxing 314000， China
　　[Abstract] Objective To investigate the effects of sevoflurane combined with sufentanil on the perioperative hemodynamics and inflammatory factors in the patients undergoing lumbar spine internal fixation. Methods A total of 80 patients undergoing selective surgery of lumbar spine internal fixation were randomly divided into the sevoflurane group （n=40）： inhaled anesthesia with sevoflurane for maintenance， and the control group（n=40）： propofol intravenous anesthesia for maintenance. Both groups were given intravenous injection of sufentanil to maintain intraoperative analgesia after induction of anesthesia. The hemodynamic parameters 5 min before induction of anesthesia（T0）， immediately after tracheal intubation （T1）， 1 min after skin incision （T2）， immediately before the removal of the tracheal tube were monitored and recorded. Peripheral venous blood at T0， T3， 8 h after operation （T4）， 24 h after operation （T5） was drawn. The levels of C-reactive protein（CRP）， tumor necrosis factor-α（TNF-α） and interleukin-6（IL-6） were measured by ELISA method. Results There was no significant difference in anesthesia induction time， operation time， intraoperative blood loss and hemodynamic indexes at each time point between the two groups. Compared with T0， CRP， IL-6 and TNF-α in the two groups began to increase at T3， reached the highest at T4（P