关键词: 丙泊酚, 直肠癌, 腹腔镜手术, 内皮系统损伤, 肝损伤

Abstract: Objective To investigate the effects of medium-long and long chain fat emulsion propofol on endothelial system and biochemical function in patients with rectal cancer undergoing laparoscopic surgery.
Methods From May 2017 to May 2019,126 patients with rectal cancer undergoing laparoscopic surgery in our hospital were randomly divided into a long-chain fat emulsion propofol group(Lgroup) and a medium-long chain fat emulsion propofol group(M group).Anesthesia effect,incidence of adverse reactions,endothelin(ET),Calcitonin gene-related peptide(CGRP) and biochemical function of the two groups were compared.
Results After laparoscopic surgery with different dosage forms of propofol,there was no difference between the two groups in the onset time of anesthesia[(2.5±1.1)minand(2.1±0.6)min,respectly],time of complete block [(1.7±0.7)min and(1.5±0.4)min],time of recovery of spontaneous breathing[(6.5±1.9)min and(5.2±1.3)min],operation time[(275.1±33.8)minand(279.6±41.2)min)],concentration of unconsciousness[(1.9±1.0)μg/mland(2.1±0.6)μg/ml],amount of propofol consumption[(1523.4±128.7)mgand(1567.9±141.2) mg](P>0.05).The anesthesia indexes and the incidence of adverse reactions of the two groups were similar(P>0.05).During the operation(T2、T3),the ET level[(133.5±19.6)pg/mland(130.4±22.0)pg/ml、(131.2±18.7)pg/mland(122.7±17.9)pg/ml,respectly] of both groups decreased,and the CGRP level[(60.4±7.8)pg/mland(63.1±8.1)pg/ml、(61.3±8.1)pg/mland(63.6±10.2)pg/ml,respectly] increased(P＜0.05);compared to that of group L,the ET level of group M was significantly lower and CGRP level was higher(P＜0.05).alanine aminotransferase(ALT) and Aspartate aminotransferase(AST) levels of two group were significantly increased after operation[(32.5±5.1)U/Land(29.0±5.3)U/L、(35.9±6.8)U/Land(32.7±6.5)U/L,respectly]compared to that of pre-operation(P＜0.05),there was no difference in two group(P>0.05).Triglyceride[TG,(1.8±0.3)mmol/L]and low-density lipoprotein[(LDL,(2.8±0.8)mmol/L]levels of group L were significantly increased(P＜0.05) after operation,and higher than that of group M [(1.4±0.7)mmol/Land(2.6±0.8)mmol/L](P＜0.05).
Conclusion Different dosage forms of propofol have similar anesthetic effects on patients with rectal cancer undergoing laparoscopic surgery,and can play a protectiverole of endothelial function by reducing ET and increasing CGRP levels,protective effection of M groupis better,there were hyper-triglyceride and hyper- low-density lipoprotein in L group.

Key words: propofol, rectal cancer, laparoscopic surgery, endothelial system injury； liver injury