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目的探讨晚期恶性肿瘤患者采用经皮射频消融术治疗时瑞芬太尼靶控输注的临床效果及安全性。方法选取2012年1月至2014年10月间收治的73例拟行射频消融术治疗的晚期恶性肿瘤患者,采用随机数字表法将其分为研究组(37例)和对照组(36例)。研究组患者采用瑞芬太尼靶控输注全身麻醉,对照组患者采用气管内插管全身麻醉。比较两组患者术前(T0)、进针即刻(T1)、治疗5 min(T2)、治疗10 min(T3)、手术完成即刻(T4)的心率(HR)、平均动脉压(MAP)、血氧饱和度(Sp O2)的监测值;比较两组患者的手术时间、苏醒时间、离室时间、术后疼痛评分及不良反应发生率的差异。结果 T0时刻两组患者的MAP、HR和Sp O2差异均无统计学意义(均P>0.05);两组患者T1、T2、T3时刻的MAP、HR和Sp O2与T0时刻比较,差异均有统计学意义(均P<0.05);在T1、T2、T3时刻,研究组患者的MAP、HR、Sp O2与对照组比较,差异均有统计学意义(均P<0.05)。研究组患者的手术时间[(34.5±4.2)min]、苏醒时间(0 min)、离室时间[(8.1±3.5)min]均显著短于对照组(均P<0.05),疼痛视觉评分(VAS)显著高于对照组(P<0.05)。研究组患者的不良反应发生率为16.2%(6/37),显著低于对照组的41.7%(15/36),差异有统计学意义(P<0.05)。结论晚期肿瘤患者采用经皮射频消融术治疗时瑞芬太尼靶控输注具有较好的麻醉效果,对患者的循环波动影响较小,术后不良反应率低。
Objective To investigate the clinical effect and safety of remifentanil target-controlled infusion in patients with advanced malignant tumors treated with percutaneous radiofrequency ablation. Methods Seventy-three patients with advanced malignant tumor who underwent radiofrequency ablation were selected from January 2012 to October 2014. The patients were divided into the study group (n = 37) and the control group (n = 36) by random number table method . Patients in the study group received remifentanil target-controlled infusion of general anesthesia, and patients in the control group received general anesthesia with endotracheal intubation. The heart rate (HR), mean arterial pressure (MAP) and total arterial pressure (MAP) of the two groups before operation (T0), immediately after the needle injection (T1), 5 min after treatment (T2), 10 min after treatment (T3) The oxygen saturation (Sp O2) of the monitoring value; the two groups of patients surgery time, recovery time, departure time, postoperative pain score and the incidence of adverse reactions. Results There were no significant differences in MAP, HR and Sp O2 between the two groups at T0 (all P> 0.05). There were significant differences in MAP, HR and Sp O2 at T1, T2 and T3 between the two groups (All P <0.05). At T1, T2 and T3, MAP, HR and Sp O2 in study group were significantly different from those in control group (all P <0.05). The patients in the study group had significantly shorter operative time (34.5 ± 4.2) min, recovery time (0 min), and room time (8.1 ± 3.5) min than those in the control group (all P <0.05) VAS) was significantly higher than the control group (P <0.05). The incidence of adverse reactions in the study group was 16.2% (6/37), which was significantly lower than that in the control group (41.7%, 15/36). The difference was statistically significant (P <0.05). Conclusion Remifentanil target controlled infusion of percutaneous radiofrequency ablation in patients with advanced cancer has good anesthetic effect, less effect on the patient’s circulatory fluctuations and low postoperative adverse reaction rate.