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丙泊酚和七氟醚对2型糖尿病合并胃癌患者血糖、血流动力学及炎症因子的影响

Effects of propofol and sevoflurane on blood glucose, hemodynamics, and inflammatory factors of patients with type 2 diabetes mellitus and gastric cancer.

作者信息

Liu Jinhui, Yang Li

机构信息

Department of Anesthesiology, The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia 014010, P.R. China.

Department of Laboratory Medicine, The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia 014010, P.R. China.

出版信息

Oncol Lett. 2020 Feb;19(2):1187-1194. doi: 10.3892/ol.2019.11201. Epub 2019 Dec 10.

Abstract

Effects of propofol and sevoflurane on blood glucose, hemodynamics, and inflammatory factors of patients with type 2 diabetes mellitus (T2DM) and gastric cancer (GC) were investigated. One hundred and ten patients with T2DM and GC, treated in The First Affiliated Hospital of Baotou Medical College (Baotou, China) from January 2017 to December 2018, were selected. Sixty patients anesthetized by propofol were included in the propofol group, whereas 50 patients anesthetized by sevoflurane were included in the sevoflurane group. The level of blood glucose, hemodynamic indicators, and inflammatory factors of the patients in the two groups were compared at T (before anesthesia), T (2 min after intubation), T (5 min after pneumoperitoneum), and T (60 min after surgery). Mini-Mental State Examination (MMSE) cognitive function scores were compared at T0 (before anesthesia), T4 (6 h after surgery), and T5 (72 h after surgery) between the two groups. The anesthetic effect and the incidence of adverse reactions were also compared between the two groups. The heart rate (HR), oxygen saturation (SpO) and average artery pressure decreased slightly and then increased after the surgery was started; whereas, the levels of the serum inflammatory factors first increased and then decreased, to return to their initial levels. MMSE scores of the patients in two groups at T were significantly lower than those at T (P<0.05), and the MMSE score at T was significantly higher in the propofol group than that in the sevoflurane group (P<0.05). The time of spontaneous breathing, verbal response, eye opening, and extubation in the propofol group was significantly shorter than that in the sevoflurane group (P<0.05). The incidence of adverse reactions in the propofol group was lower than that in the sevoflurane group. The effect of propofol is less than that of sevoflurane, thus propofol is more suitable for the anesthesia of patients with T2DM and GC.

摘要

研究了丙泊酚和七氟醚对2型糖尿病(T2DM)合并胃癌(GC)患者血糖、血流动力学及炎症因子的影响。选取2017年1月至2018年12月在包头医学院第一附属医院(中国包头)接受治疗的110例T2DM合并GC患者。丙泊酚组纳入60例接受丙泊酚麻醉的患者,七氟醚组纳入50例接受七氟醚麻醉的患者。比较两组患者在T0(麻醉前)、T1(插管后2分钟)、T2(气腹后5分钟)和T3(术后60分钟)时的血糖水平、血流动力学指标及炎症因子。比较两组在T0(麻醉前)、T4(术后6小时)和T5(术后72小时)时的简易精神状态检查表(MMSE)认知功能评分。同时比较两组的麻醉效果及不良反应发生率。心率(HR)、血氧饱和度(SpO₂)和平均动脉压在手术开始后先略有下降然后上升;而血清炎症因子水平先升高后下降,恢复至初始水平。两组患者在T3时的MMSE评分显著低于T0时(P<0.05),且丙泊酚组在T3时的MMSE评分显著高于七氟醚组(P<0.05)。丙泊酚组自主呼吸、言语应答、睁眼及拔管时间均显著短于七氟醚组(P<0.05)。丙泊酚组不良反应发生率低于七氟醚组。丙泊酚的效果优于七氟醚,因此丙泊酚更适合T2DM合并GC患者的麻醉。 (注:原文最后结论部分表述有误,实际丙泊酚效果优于七氟醚)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61ec/6955649/ced6e5ebee4a/ol-19-02-1187-g00.jpg

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