CAJ | 학술논문

目的：评价瑞芬太尼复合丙泊酚静脉麻醉在骨科手术中的麻醉效果和炎性细胞因子的影响。方法选择从2012年6月-2013年9月需要在该院接受骨科手术的90例患者，简单随机分为研究组和对照组两组，对照组患者采用芬太尼复合丙泊酚方案治疗，研究组患者采用瑞芬太尼复合丙泊酚方案治疗。观察两组患者在麻醉诱导前后以及手术开始、结束时的收缩压、舒张压和心率的变化，以及两组患者在术前、术后24 h的Hs-CRP、IL-6、TNF-α等炎性细胞因子，并且分别进行比较。结果在麻醉诱导后、手术开始、结束时研究组患者的收缩压、舒张压均明显低于对照组，差异有统计学意义（P<0.05）；研究组患者麻醉诱导后、术后24 h的TNF-α、Hs-CRP、IL-6等炎性细胞因子均明显低于对照组，差异有统计学意义（P<0.05）。结论瑞芬太尼复合丙泊酚静脉麻醉在骨科手术中的麻醉效果良好，适合临床长期推广应用。
목적：평개서분태니복합병박분정맥마취재골과수술중적마취효과화염성세포인자적영향。방법선택종2012년6월-2013년9월수요재해원접수골과수술적90례환자，간단수궤분위연구조화대조조량조，대조조환자채용분태니복합병박분방안치료，연구조환자채용서분태니복합병박분방안치료。관찰량조환자재마취유도전후이급수술개시、결속시적수축압、서장압화심솔적변화，이급량조환자재술전、술후24 h적Hs-CRP、IL-6、TNF-α등염성세포인자，병차분별진행비교。결과재마취유도후、수술개시、결속시연구조환자적수축압、서장압균명현저우대조조，차이유통계학의의（P<0.05）；연구조환자마취유도후、술후24 h적TNF-α、Hs-CRP、IL-6등염성세포인자균명현저우대조조，차이유통계학의의（P<0.05）。결론서분태니복합병박분정맥마취재골과수술중적마취효과량호，괄합림상장기추엄응용。
Objective To evaluate the anesthetic effect of remifentanil combined with propofol anesthesia in orthopedic surgery and its impact on inflammatory cytokines. Methods 90 patients needed to undergo orthopedic surgery in our hospital from June 2012 to September 2013 were selected, and simply and randomly divided into the study group and the control group. The control group were treated with fentanyl combined with propofol anesthesia, and the study group were treated with remifentanil combined with propofol anesthesia. Two groups of patients' SBP, DBP and HR changes before and after the induction of anesthesia, and at the beginning and end of the operation, Hs-CRP, IL-6, TNF-αand other inflammatory cytokines before the operation and 24h af-ter the operation were observed and compared, respectively. Results After the induction of anesthesia, at the beginning and the end of operation, the SBP, DBP of the patients in the study group were significantly lower than those of the patients in the control group, the difference was statistically significant (P<0.05); after the induction of anesthesia, 24 h after the operation, the TNF-α, Hs-CRP, IL-6, and other inflammatory cytokines of the patients in the study group were significantly lower than those of the pa-tients in the control group, the difference was statistically significant (P<0.05). Conclusion The anesthetic effect of remifentanil combined with propofol anesthesia for orthopedic surgery is better, which is suitable for long-term clinical popularization and ap-plication.