目的:探讨脑电双频指数(BIS)监测下丙泊酚闭环靶控输注用于腹腔镜下胃癌根治术的效果。方法:选取在本院接受腹腔镜下胃癌根治术治疗的原发性胃癌患者106例作为研究对象,根据麻醉方式不同分为对照组、观察组各53例。对照组接受BIS监测下手动调节丙泊酚靶控输注浓度,观察组接受BIS监测下丙泊酚闭环靶控输注。对比两组患者麻醉前(T0)、手术开始后30 min(T1)、手术结束前30 min(T2)的血流动力学指标水平、血清中炎症因子及应激激素含量的差异。结果:T0,两组血流动力学指标水平、血清中炎症因子及应激激素含量的差异无统计学意义。T1、T2,观察组血流动力学指标MAP、HR的水平低于对照组相应时间点；血清中炎症因子sICAM-1、IL-1β、IL-8、TNF-α的含量低于对照组相应时间点；血清中应激激素Cor、T4、glucagon的含量低于对照组相应时间点。结论:腹腔镜下胃癌根治术患者接受BIS监测下丙泊酚闭环靶控输注麻醉,可有效稳定患者术中血流动力学并抑制全身炎症应激反应。

Objective: To discuss the efficacy of bispectral index (BIS)-monitored closed-loop targeted-controlled infusion of propofol for laparoscopic radical operation for gastric cancer. Methods: A total of 106 patients with primary gastric cancer who underwent laparoscopic radical operation for gastric cancer in our hospital between August 2015 and February 2018 were chosen as the research subjects and divided into the control group (n=53) and the observation group (n=53) according to the different anesthesia methods. Control group of patients received BIS-monitored manually adjusted targeted-controlled infusion concentration of propofol, and observation group of patients received BIS-monitored closed-loop targeted-controlled infusion of propofol. The differences in hemodynamic index levels as well as serum contents of inflammatory factors and stress hormones were compared between the two groups of patients before anesthesia (T0), 30 min after surgery started (T1) and 30 min before surgery ended (T2). Results: At T0, the differences in hemodynamic index levels as well as serum contents of inflammatory factors and stress hormones were not statistically significant between the two groups. At T1 and T2, hemodynamic indexes MAP and HR levels of observation group were lower than those of control group at the corresponding time points; serum inflammatory factors sICAM-1, IL-1β, IL-8 and TNF-α contents were lower than those of control group at the corresponding time points; serum stress hormones Cor, T4 and glucagon contents were lower than those of control group at the corresponding time points. Conclusion: BIS-monitored closed-loop targeted-controlled infusion of propofol can effectively stabilize the intraoperative hemodynamics and inhibit the systemic inflammatory stress response in patients with laparoscopic radical operation for gastric cancer.

R614;R735.2

陕西省科学技术研究发展计划项目[2014K02-04(12) ]