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中华消化病与影像杂志(电子版) ›› 2026, Vol. 16 ›› Issue (04) : 367 -373. doi: 10.3877/cma.j.issn.2095-2015.2026.04.014

论著

甲苯磺酸瑞马唑仑与环泊酚用于胸腔镜食管癌切除术的倾向性评分匹配研究
吴清海1, 喻晓敏2, 王珊3, 李玉珍1, 孔俊丽1,()   
  1. 1442008 湖北十堰,湖北医药学院附属国药东风总医院麻醉科
    2442008 湖北十堰,湖北医药学院附属国药东风总医院疼痛科
    3442008 湖北十堰,湖北医药学院附属国药东风总医院药学部
  • 收稿日期:2026-04-19 出版日期:2026-08-01
  • 通信作者: 孔俊丽
  • 基金资助:
    2022年"聚火优才"全国药学服务科研项目(CMEAPC2023029)

Remimazolam tosylate vs. ciprofol for thoracoscopic esophagectomy for esophageal cancer: A propensity score-matched study

Qinghai Wu1, Xiaomin Yu2, Shan Wang3, Yuzhen Li1, Junli Kong1,()   

  1. 1Department of Anesthesiology, Hubei Medical College Affiliated Chinese Medicine Dongfeng General Hospital, Shiyan 442008, China
    2Department of Pain Management, Hubei Medical College Affiliated Chinese Medicine Dongfeng General Hospital, Shiyan 442008, China
    3Department of Pharmacy, Hubei Medical College Affiliated Chinese Medicine Dongfeng General Hospital, Shiyan 442008, China
  • Received:2026-04-19 Published:2026-08-01
  • Corresponding author: Junli Kong
引用本文:

吴清海, 喻晓敏, 王珊, 李玉珍, 孔俊丽. 甲苯磺酸瑞马唑仑与环泊酚用于胸腔镜食管癌切除术的倾向性评分匹配研究[J/OL]. 中华消化病与影像杂志(电子版), 2026, 16(04): 367-373.

Qinghai Wu, Xiaomin Yu, Shan Wang, Yuzhen Li, Junli Kong. Remimazolam tosylate vs. ciprofol for thoracoscopic esophagectomy for esophageal cancer: A propensity score-matched study[J/OL]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2026, 16(04): 367-373.

目的

探讨甲苯磺酸瑞马唑仑与环泊酚对胸腔镜食管癌切除患者的麻醉效果及对术后恶心呕吐(PONV)的影响。

方法

采用前瞻性队列研究设计,连续前瞻性纳入2021年6月至2024年6月于湖北医药学院附属国药东风总医院行胸腔镜食管癌切除术患者124例。根据术中麻醉用药方案分为对照组(环泊酚麻醉,60例)和观察组(甲苯磺酸瑞马唑仑麻醉,64例);为平衡组间基线混杂因素,经1∶1倾向性评分匹配后,两组最终各纳入50例患者。对比两组患者手术情况、血流动力学变化、应激反应指标及PONV发生情况。

结果

观察组麻醉恢复室(PACU)停留时间、麻醉苏醒时间、术中舒芬太尼使用量、术中瑞芬太尼使用量、术后患者自控静脉镇痛使用量均低于对照组(P<0.05);在切皮时、切除肿瘤时、缝合后三个时间,观察组的心率、平均动脉压、血氧均高于对照组(P<0.05);术后6 h,观察组肾上腺素、多巴胺、去甲肾上腺素水平均低于对照组(P<0.05);术后48 h内,观察组PONV发生率、视觉模拟评分、语言描述评分均低于对照组(P<0.05)。

结论

相较于环泊酚,甲苯磺酸瑞马唑仑用于胸腔镜食管癌切除术麻醉,可能更有助于缩短PACU停留时间及麻醉苏醒时间,减少术中阿片类药物用量,维持血流动力学稳定,减轻应激反应,降低PONV发生风险。

Objective

To investigate the anesthetic effects of remimazolam tosilate versus ciprofol in patients undergoing thoracoscopic esophagectomy and their impact on postoperative nausea and vomiting (PONV).

Methods

A prospective cohort study was conducted, enrolling 124 patients scheduled for thoracoscopic esophagectomy at Hubei Medical College Affiliated Chinese Medicine Dongfeng General Hospital from June 2021 to June 2024. Patients were divided into a control group (anesthetized with ciprofol, n=60) and an observation group (anesthetized with remimazolam tosilate, n=64) based on the intraoperative anesthetic regimen. To balance baseline covariates between groups, 1∶1 propensity score matching was performed, resulting in 50 patients in each group. The two groups were compared regarding surgical outcomes, hemodynamic changes, stress response indicators, and PONV occurrence.

Results

The observation group showed significantly shorter post-anesthesia care unit (PACU) stay time and anesthesia recovery time, as well as lower intraoperative sufentanil consumption, intraoperative remifentanil consumption, and postoperative patient-controlled intravenous analgesia usage compared with the control group (P<0.05). At skin incision, tumor resection, and after suture, heart rate, mean arterial pressure, and oxygen saturation were significantly higher in the observation group than in the control group (P<0.05). At 6 hours postoperatively, the levels of epinephrine, dopamine, and norepinephrine were significantly lower in the observation group than in the control group (P<0.05). Within 48 hours after surgery, the incidence of PONV, visual analog scale scores, and verbal descriptive scale scores were significantly lower in the observation group than in the control group (P<0.05).

Conclusion

Compared with ciprofol, remimazolam tosilate for anesthesia in thoracoscopic esophagectomy can better shorten PACU stay and anesthesia recovery time, reduce intraoperative opioid consumption, maintain hemodynamic stability, attenuate stress responses, and decrease the risk of PONV.

表1 两组胸腔镜食管癌切除术患者基线资料对比(±s
表2 两组胸腔镜食管癌切除术患者手术情况对比(±s
表3 两组胸腔镜食管癌切除术患者血流动力学变化对比
表4 两组胸腔镜食管癌切除术患者应激反应指标对比(pg/mL,±s
表5 两组胸腔镜食管癌切除术患者术后恶心呕吐发生情况对比
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