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Article(id=1239222193465381765, tenantId=1146029695717560320, journalId=1205117082300743687, issueId=1239222192311948159, articleNumber=null, orderNo=null, doi=10.14109/j.cnki.xyylc.2024.11.08, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1686499200000, receivedDateStr=2023-06-12, revisedDate=null, revisedDateStr=null, acceptedDate=1711814400000, acceptedDateStr=2024-03-31, onlineDate=1773383194557, onlineDateStr=2026-03-13, pubDate=1732464000000, pubDateStr=2024-11-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773383194557, onlineIssueDateStr=2026-03-13, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773383194557, creator=13701087609, updateTime=1773383194557, updator=13701087609, issue=Issue{id=1239222192311948159, tenantId=1146029695717560320, journalId=1205117082300743687, year='2024', volume='43', issue='11', pageStart='801', pageEnd='880', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1773383194282, creator=13701087609, updateTime=1773384015681, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1239225637551002124, tenantId=1146029695717560320, journalId=1205117082300743687, issueId=1239222192311948159, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1239225637551002125, tenantId=1146029695717560320, journalId=1205117082300743687, issueId=1239222192311948159, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=841, endPage=844, ext={EN=ArticleExt(id=1239222194182607757, articleId=1239222193465381765, tenantId=1146029695717560320, journalId=1205117082300743687, language=EN, title=Effects of esmolol on hemodynamics and inflammatory reaction during endoscopic sinus surgery in patients with sinusitis, columnId=1207314218647392369, journalTitle=Chinese Journal of New Drugs and Clinical Remedies, columnName=Original Article, runingTitle=null, highlight=null, articleAbstract=
AIM

To explore the effects of esmolol on hemodynamics and inflammatory reaction during endoscopic sinus surgery in patients with sinusitis.

METHODS

Eighty patients with sinusitis undergoing endoscopic sinus surgery were randomly divided into control group and trial group, with 40 patients in each group. The control group received routine anesthesia induction and maintenance, while the trial group received an additional 0.5 mg·kg-1 of esmolol injection during anesthesia induction and 30 μg·kg-1·min-1 of esmolol pump injection during anesthesia maintenance. The blood pressure and heart rate of patients were observed, the levels of interleukin（IL）-6, tumor necrosis factor（TNF）-α and C-reactive protein（CRP）in the blood were detected, and the recovery time, intraoperative blood loss, propofol dosage, remifentanil dosage and postoperative nausea and vomiting rate were compared between the two groups.

RESULTS

The systolic blood pressure, diastolic blood pressure, and heart rate of the trial group were lower than those in the control group at entering the operating room, the time of tracheal intubation, the beginning of surgery, 1 h after the beginning of surgery（T3）, the end of surgery（T4）, and the time of tracheal intubation was removed（P<0.01）. The levels of IL-6, TNF-α and CRP at T3 and T4 in the trial group were also lower than those in the control group（P<0.01）. The recovery time of the trial group was significantly shorter than that of the control group（P<0.01）, and the amount of intraoperative blood loss, propofol and remifentanil was significantly lower than that of the control group（P<0.01）. The incidence of postoperative nausea and vomiting in the trial group was lower than that in the control group（P<0.05）.

CONCLUSION

Esmolol is beneficial to maintain the stable hemodynamics of patients with sinusitis during endoscopic sinus surgery, can reduce inflammatory reaction, reduce intraoperative blood loss and the dosage of general anesthetics, and is relatively safe.

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目的

探索艾司洛尔对鼻窦炎患者鼻内镜术中血流动力学及炎症反应的影响。

方法

将80例拟行鼻内镜术的鼻窦炎患者随机分为2组，每组40例。对照组常规麻醉诱导和维持，试验组麻醉诱导时加用艾司洛尔0.5 mg·kg-1静脉注射，麻醉维持时加用艾司洛尔30 μg·kg-1·min-1泵注。观察2组患者的血压和心率，检测血白细胞介素（IL）-6、肿瘤坏死因子（TNF）-α和C反应蛋白（CRP）浓度，比较2组患者苏醒时间、术中出血量、丙泊酚用量、瑞芬太尼用量和术后恶心呕吐发生率。

结果

试验组患者入手术室时、气管插管时、手术开始时、手术开始后1 h（T3）、手术结束时（T4）和拔除气管插管时的收缩压、舒张压和心率均显著低于对照组（P<0.01），T3和T4的IL-6、TNF-α和CRP水平亦显著低于对照组（P<0.01）。试验组患者苏醒时间显著短于对照组（P<0.01），术中出血量、丙泊酚和瑞芬太尼用量显著低于对照组（P<0.01），术后恶心、呕吐发生率显著低于对照组（P<0.05）。

结论

艾司洛尔有利于维持鼻窦炎患者鼻内镜术中血流动力学平稳，可减轻炎症反应，减少术中出血量和全身麻醉药用量，且较安全。

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胡环宇
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张明阳，男，主治医师，博士，主要从事麻醉药理学和临床麻醉学的研究, E-mail:

胡环宇，女，副主任医师，硕士，主要从事耳鼻喉科学的研究，E-mail:

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Reg Anesth Pain Med, 2018, 43（8）: 815-818., articleTitle=Esmolol, antinociception, and its potential opioid-sparing role in routine anesthesia care, refAbstract=null)], funds=[Fund(id=1239232809403995027, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239222193465381765, awardId=YXH2022ZX02106, language=CN, fundingSource=山东省医学会临床科研资金齐鲁专项(YXH2022ZX02106), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1239232804878340839, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239222193465381765, xref=a., ext=[AuthorCompanyExt(id=1239232804882535144, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239222193465381765, companyId=1239232804878340839, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=a.Department of Anesthesiology, Tengzhou Central People’s Hospital Affiliated to Ji-ning Medical University, Tengzhou SHANDONG 277599, China,), AuthorCompanyExt(id=1239232804890923753, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239222193465381765, companyId=1239232804878340839, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=a.济宁医学院附属滕州市中心人民医院麻醉科，山东 滕州　277599，)]), AuthorCompany(id=1239232804983198445, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239222193465381765, xref=b., ext=[AuthorCompanyExt(id=1239232804991587055, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239222193465381765, companyId=1239232804983198445, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=b.Department of Otolaryngology, Tengzhou Central People’s Hospital Affiliated to Ji-ning Medical University, Tengzhou SHANDONG 277599, China), AuthorCompanyExt(id=1239232805125804785, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239222193465381765, companyId=1239232804983198445, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=b.济宁医学院附属滕州市中心人民医院耳鼻喉科，山东 滕州　277599)])], figs=[ArticleFig(id=1239232808917455734, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239222193465381765, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别时点HR/次·min-1SBP/mmHgDBP/mmHg
对照T076.8±6.6134.7±9.577.9±8.8
T197.4±11.3145.2±8.284.5±8.2
T281.2±8.5113.9±10.571.9±8.0
T373.8±7.2108.8±10.165.9±5.3
T471.5±6.5108.1±6.761.4±6.8
T586.5±8.0126.2±8.680.9±6.5
试验T074.9±7.5a133.8±11.3a76.7±7.4a
T187.1±10.8c134.3±7.5c77.5±5.8c
T273.5±7.6c104.7±9.4c66.3±7.9c
T366.2±6.2c101.4±6.8c61.3±4.2c
T465.6±6.3c100.9±6.0c57.1±4.8c
T579.6±7.7c117.0±9.2c70.5±7.7c
), ArticleFig(id=1239232809005536122, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239222193465381765, language=CN, label=表1, caption=

各观察时点血压和心率（HR）组间比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别时点HR/次·min-1SBP/mmHgDBP/mmHg
对照T076.8±6.6134.7±9.577.9±8.8
T197.4±11.3145.2±8.284.5±8.2
T281.2±8.5113.9±10.571.9±8.0
T373.8±7.2108.8±10.165.9±5.3
T471.5±6.5108.1±6.761.4±6.8
T586.5±8.0126.2±8.680.9±6.5
试验T074.9±7.5a133.8±11.3a76.7±7.4a
T187.1±10.8c134.3±7.5c77.5±5.8c
T273.5±7.6c104.7±9.4c66.3±7.9c
T366.2±6.2c101.4±6.8c61.3±4.2c
T465.6±6.3c100.9±6.0c57.1±4.8c
T579.6±7.7c117.0±9.2c70.5±7.7c
), ArticleFig(id=1239232809110393732, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239222193465381765, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别时点IL-6/ng·L-1TNF-α/ng·L-1CRP/mg·L-1
对照T05.1±2.24.7±2.01.9±1.0
T310.0±3.79.1±4.13.3±1.1
T413.9±5.412.1±5.84.4±1.4
试验T04.5±2.1a4.2±1.4a2.1±0.7a
T37.3±2.8c6.4±2.7c2.7±0.7c
T49.1±3.9c7.7±3.2c3.5±1.1c
), ArticleFig(id=1239232809206862728, tenantId=1146029695717560320, journalId=1205117082300743687, articleId=1239222193465381765, language=CN, label=表2, caption=

各观察时点炎症指标组间比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别时点IL-6/ng·L-1TNF-α/ng·L-1CRP/mg·L-1
对照T05.1±2.24.7±2.01.9±1.0
T310.0±3.79.1±4.13.3±1.1
T413.9±5.412.1±5.84.4±1.4
试验T04.5±2.1a4.2±1.4a2.1±0.7a
T37.3±2.8c6.4±2.7c2.7±0.7c
T49.1±3.9c7.7±3.2c3.5±1.1c
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艾司洛尔对鼻窦炎患者鼻内镜术中血流动力学及炎症反应的影响
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张明阳 a , 韩洋 a , 胡环宇 b
中国新药与临床杂志 | 论著 2024,43(11): 841-844
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中国新药与临床杂志 | 论著 2024, 43(11): 841-844
艾司洛尔对鼻窦炎患者鼻内镜术中血流动力学及炎症反应的影响
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张明阳a , 韩洋a, 胡环宇b
作者信息
  • a.济宁医学院附属滕州市中心人民医院麻醉科，山东 滕州　277599，
  • b.济宁医学院附属滕州市中心人民医院耳鼻喉科，山东 滕州　277599

    • 张明阳，男，主治医师，博士，主要从事麻醉药理学和临床麻醉学的研究, E-mail:

    胡环宇，女，副主任医师，硕士，主要从事耳鼻喉科学的研究，E-mail:

通讯作者:

胡环宇
Effects of esmolol on hemodynamics and inflammatory reaction during endoscopic sinus surgery in patients with sinusitis
Ming-yang ZHANGa , Yang HANa, Huan-yu HUb
Affiliations
  • a.Department of Anesthesiology, Tengzhou Central People’s Hospital Affiliated to Ji-ning Medical University, Tengzhou SHANDONG 277599, China,
  • b.Department of Otolaryngology, Tengzhou Central People’s Hospital Affiliated to Ji-ning Medical University, Tengzhou SHANDONG 277599, China
出版时间: 2024-11-25 doi: 10.14109/j.cnki.xyylc.2024.11.08
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摘要
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目的

探索艾司洛尔对鼻窦炎患者鼻内镜术中血流动力学及炎症反应的影响。

方法

将80例拟行鼻内镜术的鼻窦炎患者随机分为2组，每组40例。对照组常规麻醉诱导和维持，试验组麻醉诱导时加用艾司洛尔0.5 mg·kg-1静脉注射，麻醉维持时加用艾司洛尔30 μg·kg-1·min-1泵注。观察2组患者的血压和心率，检测血白细胞介素（IL）-6、肿瘤坏死因子（TNF）-α和C反应蛋白（CRP）浓度，比较2组患者苏醒时间、术中出血量、丙泊酚用量、瑞芬太尼用量和术后恶心呕吐发生率。

结果

试验组患者入手术室时、气管插管时、手术开始时、手术开始后1 h（T3）、手术结束时（T4）和拔除气管插管时的收缩压、舒张压和心率均显著低于对照组（P<0.01），T3和T4的IL-6、TNF-α和CRP水平亦显著低于对照组（P<0.01）。试验组患者苏醒时间显著短于对照组（P<0.01），术中出血量、丙泊酚和瑞芬太尼用量显著低于对照组（P<0.01），术后恶心、呕吐发生率显著低于对照组（P<0.05）。

结论

艾司洛尔有利于维持鼻窦炎患者鼻内镜术中血流动力学平稳，可减轻炎症反应，减少术中出血量和全身麻醉药用量，且较安全。

艾司洛尔  /  鼻窦炎  /  心率  /  血压  /  炎症反应  /  鼻内镜
AIM

To explore the effects of esmolol on hemodynamics and inflammatory reaction during endoscopic sinus surgery in patients with sinusitis.

METHODS

Eighty patients with sinusitis undergoing endoscopic sinus surgery were randomly divided into control group and trial group, with 40 patients in each group. The control group received routine anesthesia induction and maintenance, while the trial group received an additional 0.5 mg·kg-1 of esmolol injection during anesthesia induction and 30 μg·kg-1·min-1 of esmolol pump injection during anesthesia maintenance. The blood pressure and heart rate of patients were observed, the levels of interleukin（IL）-6, tumor necrosis factor（TNF）-α and C-reactive protein（CRP）in the blood were detected, and the recovery time, intraoperative blood loss, propofol dosage, remifentanil dosage and postoperative nausea and vomiting rate were compared between the two groups.

RESULTS

The systolic blood pressure, diastolic blood pressure, and heart rate of the trial group were lower than those in the control group at entering the operating room, the time of tracheal intubation, the beginning of surgery, 1 h after the beginning of surgery（T3）, the end of surgery（T4）, and the time of tracheal intubation was removed（P<0.01）. The levels of IL-6, TNF-α and CRP at T3 and T4 in the trial group were also lower than those in the control group（P<0.01）. The recovery time of the trial group was significantly shorter than that of the control group（P<0.01）, and the amount of intraoperative blood loss, propofol and remifentanil was significantly lower than that of the control group（P<0.01）. The incidence of postoperative nausea and vomiting in the trial group was lower than that in the control group（P<0.05）.

CONCLUSION

Esmolol is beneficial to maintain the stable hemodynamics of patients with sinusitis during endoscopic sinus surgery, can reduce inflammatory reaction, reduce intraoperative blood loss and the dosage of general anesthetics, and is relatively safe.

esmolol  /  sinusitis  /  heart rate  /  blood pressure  /  inflammatory reaction  /  nasal endoscopy
张明阳, 韩洋, 胡环宇. 艾司洛尔对鼻窦炎患者鼻内镜术中血流动力学及炎症反应的影响. 中国新药与临床杂志, 2024 , 43 (11) : 841 -844 . DOI: 10.14109/j.cnki.xyylc.2024.11.08
Ming-yang ZHANG, Yang HAN, Huan-yu HU. Effects of esmolol on hemodynamics and inflammatory reaction during endoscopic sinus surgery in patients with sinusitis[J]. Chinese Journal of New Drugs and Clinical Remedies, 2024 , 43 (11) : 841 -844 . DOI: 10.14109/j.cnki.xyylc.2024.11.08
正文
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鼻窦炎是临床上常见的耳鼻喉科疾病，其发生机制尚未明确，可能与变态反应和炎症反应有关[1]，鼻窦炎的反复发作会导致白细胞介素（IL）-6、肿瘤坏死因子（TNF）-α、C反应蛋白（CRP）等炎症因子升高[2]。手术医师在鼻窦炎患者鼻内镜术中常局部使用肾上腺素收缩血管减少出血，这会导致患者血压、心率（HR）升高，增加了心脑血管并发症的发生风险[3]。艾司洛尔（esmolol）为短效选择性肾上腺素β1受体阻滞药，可以在较短时间内抑制HR加快和血压升高[4]。此外，艾司洛尔能激活离体神经细胞膜上的G蛋白，产生突触后或突触前抑制，减少神经介质的释放，具有减轻炎症反应、抑制炎性痛的作用[5]，进而可减少围手术期阿片类药物的使用量[6]。本研究观察艾司洛尔对鼻窦炎患者全身麻醉（全麻）下鼻内镜手术期间血流动力学和炎症反应的影响，以期提高鼻窦炎患者鼻内镜术的治疗效果。
资料与方法
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一般资料
选取2022年9月至2023年4月在本院行全麻下鼻内镜术的鼻窦炎患者，ASA分级Ⅰ~Ⅱ级，年龄20 ~ 60岁。排除心血管系统、神经系统、呼吸系统和精神疾病，术前签署知情同意书。研究经本院伦理委员会审核通过（伦审号：2022-伦理审查-11）。共纳入患者80例，随机分为对照组和试验组，每组40例。
麻醉方法
患者入手术室后常规监测心电图、血压和血氧饱和度，使用脑电双频指数（BIS）监测麻醉深度。对照组常规全麻诱导，静脉注射（静注）咪达唑仑0.05 mg·kg-1、舒芬太尼0.3 μg·kg-1、丙泊酚2 mg·kg-1、罗库溴铵0.6 mg·kg-1；麻醉维持：静脉泵入丙泊酚5 mg·kg-1·h-1、瑞芬太尼0.2 μg·kg-1·min-1，根据血压和HR调整剂量，维持BIS 40~60。试验组在对照组基础上，麻醉诱导增加艾司洛尔（齐鲁制药有限公司，批号：2D0221C82）0.5 mg·kg-1，麻醉维持增加艾司洛尔30 μg·kg-1·min-1，至拔除气管导管后停止泵入艾司洛尔。手术开始前给予肾上腺素溶液（氯化钠注射液5 mL中加入1:1 000的肾上腺素2滴）2 mL双侧鼻黏膜下注射，患者出现心动过缓（HR < 50次·min-1）时静注阿托品0.3 mg，出现低血压［收缩压（SBP）< 90 mmHg］时静注间羟胺0.5 mg。
观察指标
记录2组患者入手术室时（T0）、气管插管时（T1）、手术开始时（T2）、手术开始后1 h（T3）、手术结束时（T4）、拔除气管插管时（T5）的SBP、舒张压（DBP）和HR。于T0、T3和T4采集静脉血，检测IL-6（化学发光法）、TNF-α（化学发光法）和CRP（免疫比浊法）浓度。观察比较2组患者术中出血量、丙泊酚和瑞芬太尼用量、苏醒时间（T4至T5的时间），记录2组术中心动过缓、低血压和术后恶心、呕吐的发生情况。
统计学方法
采用SPSS 18.0软件进行统计分析。计量资料以均数±标准差表示，组间比较采用独立样本t检验；计数资料比较采用χ2检验。P<0.05为差异有显著意义。
结果
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一般资料
对照组男性28例，女性12例，患者年龄（37.8±9.3）岁，体重（65.1±6.9）kg，身高（168.3±6.4）cm，手术时间（94.1±13.6）min；试验组男性30例，女性10例，患者年龄（36.5±10.1）岁，体重（64.5±7.3）kg，身高（167.7±5.5）cm，手术时间（89.3±10.3）min。2组患者年龄、性别比例、身高、体重和手术时间比较，差异均无显著意义（P>0.05）。
血压和HR
2组T0的SBP、DBP和HR比较，均无显著差异（P>0.05）。T1~T5，试验组的SBP、DBP和HR均低于对照组，差异有非常显著意义（P<0.01）。见表1。
炎症指标
2组T0的IL-6、TNF-α和CRP水平比较，均无显著差异（P>0.05）。试验组T3、T4的IL-6、TNF-α和CRP水平均低于对照组，差异有非常显著意义（P<0.01）。见表2。
出血量、苏醒时间、全麻药用量
试验组术中丙泊酚用量、瑞芬太尼用量、术中出血量和患者苏醒时间分别为（439.0±51.9）mg、（451.3±78.8）μg、（87.5±38.8）mL、（14.9±3.7）min，对照组分别为（537.3±65.4）mg、（603.0±104.3）μg、（113.8±33.9）mL、（22.9±4.2）min。试验组术中丙泊酚用量、瑞芬太尼用量、术中出血量和患者苏醒时间均低于对照组，差异均有非常显著意义（P<0.01）。
不良反应
对照组发生心动过缓3例（8%）、低血压4例（10%）、恶心11例（28%）、呕吐7例（18%），试验组发生心动过缓5例（13%）、低血压7例（18%）、恶心3例（8%）、呕吐1例（3%）。2组心动过缓、低血压发生率比较无显著差异（P>0.05），试验组恶心、呕吐发生率显著低于对照组（P<0.05）。2组不良反应程度均不严重，对症处理后可缓解或自行恢复正常。
讨论
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人体中的IL可介导B细胞和T细胞分化、增殖及活化，发挥免疫调节功能，有研究发现IL-6和TNF-α在鼻窦炎的发生、发展中起重要作用[7]。IL-6、TNF-α、CRP是炎症反应的敏感标记物，正常机体中的含量较低，当机体受损或发生炎症反应时，其水平会在短时间内明显升高[8]。艾司洛尔可能通过抑制细胞焦亡经典通路NLRP3/caspase-1/GSDMD相关蛋白的表达，降低IL等炎症因子水平[9]。既往有研究发现，艾司洛尔能够减轻胸腹部等大手术患者术中的炎症反应[10，11]。本研究中，2组手术开始后IL-6、TNF-α和CRP的水平均有所升高，且随着手术的进行，表达水平进一步升高，而试验组IL-6、TNF-α和CRP的水平显著低于对照组，提示鼻内镜手术创伤会加重机体炎症反应，而艾司洛尔能够抑制IL-6、TNF-α和CRP的表达升高，进而减轻炎症反应。
为减少出血，本研究中在鼻内镜术开始前给予肾上腺素稀释后鼻黏膜下注射，这会引起血管收缩，导致患者血压升高和HR加快。同时，鼻内镜手术期间全麻气管插管和手术创伤等伤害性刺激会诱发患者应激反应，导致患者血压升高和HR加快。本研究中麻醉后2组血压和HR均升高，但试验组T1~T5的SBP、DBP和HR均显著低于对照组，提示艾司洛尔可降低患者血液动力学的波动。此外，试验组丙泊酚和瑞芬太尼用量均显著少于对照组，与既往研究结果[6]相似。中枢神经系统中β受体可能参与了痛觉的调控，而艾司洛尔作为β受体阻滞药可能通过影响中枢神经系统对痛觉的调控而产生镇痛作用[12]。BAHR等[13]的研究显示，艾司洛尔还可通过降低心输出量和肝血流量，减慢阿片类镇痛药代谢，进而减少阿片类镇痛药的使用量。此外，本研究中2组心动过缓、低血压发生率比较无显著差异，而试验组恶心、呕吐发生率显著低于对照组，提示艾司洛尔相对安全。
综上所述，在鼻窦炎患者鼻内镜术中使用艾司洛尔有利于患者血流动力学平稳，还可减轻患者炎症反应，减少术中出血量和全麻药使用量，缩短苏醒时间，且较安全。但本研究样本量偏小，未检测艾司洛尔的血药浓度，没有进行艾司洛尔血药浓度与药效的相关分析，且仅观察了3个时点炎症因子的水平，艾司洛尔在鼻内镜术中应用的确切效果和对患者术后炎症反应的影响有待进一步研究。
基金
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  • 山东省医学会临床科研资金齐鲁专项(YXH2022ZX02106)
文献
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参考文献 引证文献
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2024年第43卷第11期
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doi: 10.14109/j.cnki.xyylc.2024.11.08
  • 接收时间：2023-06-12
  • 首发时间：2026-03-13
  • 出版时间：2024-11-25
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  • 收稿日期：2023-06-12
  • 录用日期：2024-03-31
基金
山东省医学会临床科研资金齐鲁专项(YXH2022ZX02106)
作者信息
    a.济宁医学院附属滕州市中心人民医院麻醉科，山东 滕州　277599，
    b.济宁医学院附属滕州市中心人民医院耳鼻喉科，山东 滕州　277599

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胡环宇
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https://castjournals.cast.org.cn/joweb/zgxyylczz/CN/10.14109/j.cnki.xyylc.2024.11.08
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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