摘要
目的:观察老年腹腔镜胃肠肿瘤切除术患者使用七氟醚联合右美托咪定复合麻醉后,机体应激反应和脑氧代谢的变化情况。方法:将我院2020年1月至2020年12月期间收治的100例老年腹腔镜胃肠肿瘤切除术患者根据随机数字表法分为对照组(n=50,七氟醚麻醉)和研究组(n=50,右美托咪定联合七氟醚麻醉)。观察两组血流动力学、应激反应、脑氧代谢、认知功能和不良反应。结果:两组手术60 min(T1)~手术后30 min(T3)时间点较麻醉诱导前(T0)时间点心率(HR)先下降后升高,平均动脉压(MAP)先升高后下降(P<0.05)。研究组T1~T3时间点HR及MAP低于对照组(P<0.05)。两组术后3 d多巴胺(DA)、肾上腺素(AD)、去甲肾上腺素(NE)水平升高,但研究组低于对照组(P<0.05)。两组术后3 d血氧含量差(DajvO_(2))和脑氧摄取率(CERO_(2))下降,且研究组低于对照组(P<0.05)。研究组术后6 h、术后1 d、术后3 d简易精神状态检查量表(MMSE)评分高于对照组(P<0.05)。两组不良反应发生率,对比无显著性差异(P>0.05)。结论:七氟醚联合右美托咪定应用于老年腹腔镜胃肠肿瘤切除术患者,可有效减轻机体应激反应,减轻机体认知功能损伤,维持血流动力学稳定和脑氧代谢。
Objective:To observe the effects of dexmedetomidine combined with sevoflurane on cerebral oxygen metabolism and stress response in elderly patients undergoing laparoscopic gastrointestinal tumor resection.Methods:100 elderly patients undergoing laparoscopic gastrointestinal tumor resection who were treated in our hospital from January 2020 to December 2020 were divided into control group(n=50,sevoflurane anesthesia)and study group(n=50,dexmedetomidine combined with sevoflurane anesthesia)by random number table method.Hemodynamics,stress response,cerebral oxygen metabolism,cognitive function and adverse reactions of two groups were observed.Results:60 min(T1)to 30 min(T3)after operation,The heart rate(HR)of the two groups first decreased and then increased compared with the time point before induction of anesthesia(T0),and the mean arterial pressure(MAP)first increased and then decreased(P<0.05).HR at T1~T3 time points in the study group were lower than those in the control group(P<0.05).The dopamine(DA),epinephrine(AD)and norepinephrine(NE)levels in two groups at 3 d after operation were increased,but the study group was lower than the control group(P<0.05).The difference of blood oxygen content(DajvO_(2))and cerebral oxygen uptake rate(CERO_(2))in both groups at 3d after operation decreased,but the study group was lower than the control group(P<0.05).The scores of mini mental state examination scale(MMSE)in the study group at 6h,1d and 3d after operation were higher than those in the control group(P<0.05)There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Sevoflurane combined with dexmedetomidine in elderly patients undergoing laparoscopic gastrointestinal tumor resection can effectively reduce the body’s stress response,reduce the damage of cognitive function,and maintain hemodynamic stability and cerebral oxygen metabolism.
作者
叶霞
高永涛
王菲
陶莹
张媛媛
林昊
YE Xia;GAO Yong-tao;WANG Fei;TAO Ying;ZHANG Yuan-yuan;LIN Hao(Affiliated Hospital of Nantong University,Nantong,Jiangsu,226000,China;Department of Anesthesiology,Nanjing Jiangbei Hospital Affiliated to Nantong University,Nanjing,Jiangsu.210000,China;Department of Anesthesiology,The Second Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu,210000,China;Department of General Surgery,Nanjing Jiangbei Hospital Affiliated to Nantong University,Nanjing,Jiangsu,210000,China)
出处
《现代生物医学进展》
CAS
2022年第10期1909-1913,共5页
Progress in Modern Biomedicine
基金
江苏省自然科学基金青年基金项目(BK2017447)。
关键词
右美托咪定
七氟醚
老年
腹腔镜
胃肠肿瘤切除术
脑氧代谢
Dexmedetomidine
Sevoflurane
Elderly
Laparoscopic
Gastrointestinal tumor resection
Cerebral oxygen metabolism
