胡国慧

[摘要] 目的 研究瑞芬太尼復合丙泊酚全凭静脉麻醉在老年脊柱手术中的应用效果。方法 该次方便选择的110例研究对象均来自于2015年9月—2017年9月期间该院接受脊柱手术治疗的老年患者，分为两组，实验组给予瑞芬太尼复合丙泊酚全凭静脉麻醉，对照组给予七氟烷吸入麻醉。分析比较麻醉效果。结果 实验组心率、DBP、苏醒时间（68.12±13.52）次/min、（55.54±6.69）mmHg、（5.76±0.91）h，明显优于对照组（73.65±7.88）次/min、（69.52±12.19）mmHg、（12.01±0.79）h（t=-2.620 7、-7.456 1、-3.791 8，P=0.030 5、0.049 6、0.046 6；实验组恢复自主呼吸、睁眼、拔管的时间分别为（10.22±2.15）min、（4.01±0.78）min、（11.19±1.32）min，均低于对照组的（18.72±2.36）min、（7.31±1.02）min、（19.82±2.35）min（t=-19.745 5、-19.059 5、-23.745 3，P=0.018 5、0.032 5、0.026 3）；实验组不良反应发生率1.82%，明显低于对照组的14.55%（χ2=6.075 8，P=0.013 7）。结论 针对脊柱手术的老年患者，采用瑞芬太尼与丙泊酚复合麻醉，麻醉效果更佳，血流动力学稳定，且不易发生并发症，临床上值得推广。

[关键词] 瑞芬太尼；丙泊酚；静脉麻醉；老年人脊柱手术

[中图分类号] R614 [文献标识码] A [文章编号] 1674-0742（2018）03（c）-0111-03

Application of Remifentanil and Propofol Total Intravenous Anesthesia in the Spine Surgery of Senile People

HU Guo-hui

Department of Anesthesia， Wenshan Hospital of TCM， Wenshan， Yunnan Province， 663099 China

[Abstract] Objective To study the application effect of remifentanil and propofol total intravenous anesthesia in the spine surgery of senile people. Methods 110 cases of senile patients with spine surgery treated in our hospital from September 2015 to September 2017 were conveniently selected and divided into two groups， the experimental group used the remifentanil and propofol for intravenous anesthesia， while the control group used the inhaled anesthesia of sevoflurane， and the anesthesia effect was analyzed and compared. Results The heart rate， DBP， and awakening time in the experimental group were obviously better than those in the control group[（68.12±13.52）times/min，（55.54±6.69）mmHg，（5.76±0.91）h vs （73.65±7.88）times/min，（69.52±12.19）mmHg，（12.01±0.79）h]（t=-2.620 7，-7.456 1，-3.791 8，P=0.030 5，0.049 6，0.046 6）， and the recovery of spontaneous breathing， eye opening and extubation time in the experimental group were lower than those in the control group， [（10.22±2.15）min，（4.01±0.78）min，（11.19±1.32）min vs （18.72±2.36）min，（7.31±1.02）min，（19.82±2.35）min]（t=-19.745 5，-19.059 5，-23.745 3，P=0.018 5，0.032 5，0.026 3）， and the incidence rate of adverse reactions in the experimental group was obviously lower than that in the control group（1.82% vs 14.55%）（χ2=6.075 8，P=0.013 7）. Conclusion The anesthesia effect of remifentanil and propofol in the spine surgery of senile people is better with steady hemodynamics， and the complications are not easy to occur， and it is worth promotion in clinic.

[Key words] Remifentanil； Propofol； Intravenous anesthesia； Senile patients with spine surgery

随着老龄化的发展，老年脊柱手术患者逐渐增多，手术可对机体造成创伤，且术后常有疼痛产生，可引发手术应激反应，使患者术后恢复受到影响。同时，由于老年人各项身体器官老化，新陈代谢速度慢，在脊柱手术中进行麻醉，会对老年患者机体产生不良影响[1-2]。为进一步探讨老年患者展开脊柱手术时，采用芬太尼复合丙泊酚全凭静脉的麻醉效果，该研究就该院2015年9月—2017年9月期间接收并行脊柱手术治疗的老年患者110例为两组，分别通过上述方案、吸入七氟烷实施麻醉，现报道如下。

1 资料与方法

1.1 一般资料

该次方便选择的110例研究对象均来自于在该院接受脊柱手术治疗的老年患者，根据麻醉方式分为两组，实验组给予瑞芬太尼复合丙泊酚全凭静脉麻醉，对照组给予七氟烷吸入麻醉。……