摘要
目的:探讨右美托咪定不同负荷量对消化道肿瘤患者术后肠功能恢复的影响。方法:选取2019年2月至2021年3月该院收治的择期行消化道肿瘤手术的患者108例,按随机数字表法分成A、B和C组,每组36例。A、B组患者于麻醉诱导前10 min分别静脉泵入右美托咪定负荷量0.5、1.0μg/kg,术中均以0.5μg/(kg·h)持续输注至手术缝皮结束前10 min。C组患者静脉泵入等量0.9%氯化钠注射液。三组患者均以相同方法予以麻醉诱导与维持。记录三组患者泵注右美托咪定前(T_(0))、气管插管后(T_(1))、右美托咪定停用时(T_(2))、拔管即刻(T_(3))和拔管后30 min(T_(4))时的平均动脉压(MAP)、心率(HR),于上述时间点检测血清皮质醇(Cor)、去甲肾上腺素(NE)水平,记录三组患者排气、排便时间,并观察三组患者术后麻醉相关并发症发生情况。结果:T_(1)—T_(4)时,A、B组患者MAP、HR,血清Cor、NE水平较C组明显降低;且B组患者MAP、HR,血清Cor、NE水平较A组明显降低,差异均有统计学意义(P<0.05)。A、B组患者排气、排便时间均较C组明显缩短,且B组患者排气、排便时间较A组明显缩短,差异均有统计学意义(P<0.05)。B组患者拔管时躁动发生率较C组明显降低,差异均有统计学意义(P<0.05)。结论:在消化道肿瘤患者手术中应用右美托咪定可有效控制血流动力学及应激反应,显著降低拔管时躁动发生率,明显缩短术后肠功能恢复时间;且1.0μg/kg负荷量的右美托咪定静脉泵注后以0.5μg/(kg·h)持续输注的效果更佳。
OBJECTIVE:To probe into the effects of different loading doses of dexmedetomidine on postoperative recovery of intestinal function in patients with gastrointestinal tumor.METHODS:Totally 108 patients undergoing gastrointestinal tumor surgery in this hospital from Feb.2019 to Mar.2021 were extracted to be divided into the group A,B and C via the random number table,with 36 patients in each group.In group A and B,0.5μg/kg and 1.0μg/kg of dexmedetomidine were pumped intravenously 10 min before anesthesia induction,and 0.5μg/(kg·h)of dexmedetomidine was infused continuously until 10 min before the end of skin suture.In group C,the same volume of 0.9%sodium chloride injection was pumped intravenously.Three groups were given anesthesia induction and maintenance in the same way.The mean arterial pressure(MAP)and heart rate(HR)were recorded before dexmedetomidine pumping(T_(0)),after endotracheal intubation(T_(1)),at withdrawal of dexmedetomidine(T_(2)),immediately after extubation(T_(3)),and 30 min after extubation(T_(4))in three groups were recorded,the serum levels of cortisol(Cor)and norepinephrine(NE)were detected after collecting the blood samples at the above time points,the time of exhaust and defecation was recorded,and the incidence of postoperative anesthesia related complications was observed.RESULTS:From T_(1)to T_(4),the MAP,HR,serum Cor and NE levels in group A and B were significantly lower than those in group C,and the MAP,HR,serum Cor and NE levels in group B were significantly lower than those in group A,with statistically significant differences(P<0.05).The time of exhaust and defecation in group A and B was significantly shorter than that in group C,and the time of exhaust and defecation in group B was significantly shorter than that in group A,with statistically significant differences(P<0.05).The incidence of agitation during extubation in group B was significantly lower than that in group C,with statistically significant differences(P<0.05).CONCLUSIONS:The application of dexmedetomidine during
作者
齐超
张哲哲
张晓玲
刘红曼
QI Chao;ZHANG Zhezhe;ZHANG Xiaoling;LIU Hongman(Dept.of Anesthesiology,Langfang People’s Hospital,Hebei Langfang 065099,China;Dept.of Gastroenterology,Langfang People’s Hospital,Hebei Langfang,065099,China)
出处
《中国医院用药评价与分析》
2022年第1期51-54,58,共5页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
河北省医学科学研究课题计划项目(No.20201308)。
关键词
右美托咪定
消化道肿瘤
血流动力学
应激反应
肠功能恢复
Dexmedetomidine
Gastrointestinal tumor
Hemodynamics
Stress response
Intestinal function recovery
