The cerebral protection effect of parecoxib sodium in elderly patients with colon and rectum carcinoma operation
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摘要: 目的 观察帕瑞昔布钠对老年结直肠癌根治术患者脑保护的影响。 方法 选择2015年1月—2017年1月浙江省荣军医院收治的符合结直肠癌根治术手术指征的老年患者72例纳入本研究,随机分为2组,每组36例。麻醉诱导前,观察组静脉注射帕瑞昔布钠0.6 mg/kg,对照组静脉注射等剂量生理盐水,之后2组均静注0.3 mg长托宁、0.05 mg/kg咪达唑仑、3μg/kg芬太尼、1.0~1.5 mg/kg丙泊酚、0.15 mg/kg苯磺酸顺-阿曲库铵行麻醉诱导,术中均泵注4~8 mg/(kg·h)丙泊酚及间断静注0.05 mg芬太尼、5 mg顺式-阿曲库铵维持脑电双频指数(BIS)于40~60之间。记录2组患者入室后、诱导后、气管插管后、手术1 h、手术结束血流动力学指标;并于入室后、手术结束、术后12 h、术后24 h、术后48 h抽取静脉血测定血清S100β蛋白、神经元特异性烯醇化酶(NSE)水平,进行统计学分析;比较2组术中不良反应发生率。 结果 观察组T2、T3时刻MAP及HR水平均低于对照组(P<0.05),且对照组T2、T3时刻MAP及HR水平均低于T0时刻(P<0.05),观察组血流动力学更为平稳;观察组给予帕瑞昔布钠后,T1、T2、T3、T4时刻血清S100β蛋白、NSE水平均低于对照组(均P<0.05);且2组T1、T2、T3、T4血清S100β蛋白、NSE水平均高于T0水平(均P<0.05)。2组患者不良反应发生率比较差异无统计学意义(P>0.05)。 结论 帕瑞昔布钠对老年结直肠癌根治术患者血流动力学平稳,且脑保护作用佳,临床应用安全。Abstract: Objective To observe cerebral protection effect of parecoxib sodium in elderly patients with colon and rectum carcinoma operation. Methods Seventy-two cases of elderly patients with colorectal cancer surgery included in the study were randomly divided into 2 groups, 36 cases in each group. The observation group and control group were respectively accepted intravenous injection of parecoxib sodium of 0. 6 mg/kg before induction, normal saline after intravenous injection of 0. 3 mg Thorning, 0. 05 mg/kg midazolam, fentanyl 3 g/kg, 1-1. 5 mg/kg 0. 15 mg/kg propofol, CIS atracurium besylate for induction of anesthesia, intraoperative infusion 4-8 mg/(kg·h) propofol and intermittent intravenous fentanyl 0. 05 mg, 5 mg cis-atracurium to maintain BIS in 40-60. Two groups were recorded after the burglary, after induction of surgical 1 h after tracheal intubation, the end of surgery, hemodynamic indexes; and after the burglary, the end of surgery, postoperative 12 h, postoperative 24 h, postoperative 48 h venous blood serum S100 protein, neuron specific enolase (NSE) levels were statistically analyzed; the incidence of adverse reactions were compared between the two groups. Results The T2, T3 time MAP and HR level in the observation group were lower than the control group (P < 0. 05), T2, T3 time MAP and HR were lower than those of T0 (P < 0. 05), the observation group was more stable hemodynamics; the observation group was given parecoxib sodium, T1, T2, T3, T4, serum S100 beta protein level of NSE were lower than the control group (P < 0. 05); and the 2 groups of T1, T2, T3, T4, serum S100 protein, NSE levels were higher than the level of T0 (P < 0. 05). Two groups of patients with adverse reaction rate difference was significant (P > 0. 05). Conclusion For elderly colorectal cancer root treatment of patients, Pparecoxib sodium can stable blood flow dynamics, and the brain protection effect is good, safe in clinical application.
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Key words:
- Parecoxib sodium /
- Elderly /
- Colorectal resection /
- Hemodynamics /
- Cerebral protection
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