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论著:瑞米芬太尼对肺癌根治术患者术中房颤发生率的影响
Effect of Continuous Remifentanil Administration on Incidence Rate of Intra-Operative Atrial Fibrillation in Patients Undergoing Radical Operation for Lung Cancer
吴德华 张晓峰 徐伟兴 曹晖 徐美英
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作者单位:上海交通大学附属胸科医院麻醉科
中文关键字:瑞米芬太尼;根治术;肺癌;心房颤动
英文关键字:Remifentanil; Radical operation; Lung cancer; Atrial fibrillation
中文摘要:目的:研究瑞米芬太尼对肺癌根治术患者术中房颤的影响。方法:通过麻醉信息系统选择2008年1月—2011年3月记录完整的肺癌根治术患者的麻醉记录单。依据是否应用瑞米芬太尼分为瑞芬组和非瑞芬组。2组患者采用相同的静脉麻醉诱导方法。瑞芬组在麻醉诱导后开始予瑞米芬太尼0.1~0.2 μg/(kg·min)。非瑞芬组麻醉维持采用间断静脉注入芬太尼。统计2组患者房颤的发生率,根据不同性别、不同年龄进行分层比较。 结果:与非瑞芬组比较,瑞芬组患者术中房颤发生率均有降低趋势,总体房颤发生率下降1.01%,其中男性和女性患者中降低幅度均为1.2%。老年患者中降低幅度为2.2%:其中老年男性患者中降低幅度为2.8%,老年女性患者中降低幅度为2.2%。年轻患者中降低幅度轻微。结论:瑞米芬太尼有降低肺癌根治术中房颤发生率的趋势,在老年男性患者中较明显。
英文摘要:Objective: To investigate the effects of continuous remifentanil administration on incidence rate of intra-operative atrial fibrillation in patients undergoing radical operation for lung cancer. Methods: Anesthesia records in patients undergoing radical operation for lung cancer between Jan. 2008 and Mar. 2011 were collected from electrical anesthesia recording system in our hospital. A total of 3058 patients’ anesthesia recods med our criterion were analyzed. Those patients were divided into 2 groups: Remifentanil group and Non-remifentanil group. Remifentanil with a dose of 0.1-0.2μg/kg/min was continuously adiminstrated after anesthesia induction was completed in the Remifentanil group. Fentanyl was administrated intermittently according to anesthesia level requirement in the Non-remifentanil group. The incidence rate of atrial fibrillation was analyzed in both groups. Results: There was a descreasing tendency about the incidence rates of intra-operative atrial fibrillation for patients in Remifentanil group comparing with that in Non-remifentanil group. The total incidence rates of intra-operative atrial fibrillation descreased from 5.25% in patients of the Non-remifentanil group to 4.24% in those of the Remifentanil group. The descreasing extent of the incidence rate of intra-operative atrial fibrillation in male and female patients arrived at 1.2%, 2.2% in the old patient group, 2.8% in the older male patient group, 2.2% in the older female patients group. Conclusions: A descreasing tendency about the incidence rates of intra-operative atrial fibrillation was observed in patients with remifentanil continuously administrated during operation comparing with in patients with no remifentanil administrated, especially in older male patients.
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