摘要
目的探讨右美托咪定对行全麻下腹腔镜胃癌根治术病人术后血流动力学参数、应激及躁动反应等指标的影响。方法以2019年1月—2021年12月在恩施土家族苗族自治州中心医院行腹腔镜胃癌根治术病人131例为研究对象,采用随机数字表法分为对照组(66例)与观察组(65例),两组均采用全身麻醉术,对照组在手术结束前10 min给予纳布啡,观察组给予右美托咪定联合纳布啡,比较两组手术结束时(T_(0))、拔除气管导管前(T_(1))、拔除气管导管即刻(T_(2))、拔除气管导管后5 min(T_(3))及10 min(T_(4))时的心率、平均动脉压、应激及炎性反应相关生物学指标、SAS评分、躁动率及拔管期间呛咳程度等指标。结果观察组T_(1)、T_(2)时的心率、平均动脉压均低于对照组(F=24.725~137.167,P<0.05)。观察组T_(2)、T_(4)时的血糖、皮质醇、肾上腺素、肿瘤坏死因子-α、白细胞介素-6、C-反应蛋白等均低于对照组(F=4.913~200.516,P<0.05)。观察组SAS评分、躁动率和拔管时呛咳程度等均低于对照组(t=2.416,χ^(2)=5.715,Z=2.053,P<0.05)。结论右美托咪定可减轻全麻下腹腔镜胃癌根治术病人术后血流动力学参数波动、应激及炎症反应水平,降低气管拔管时躁动与拔管期间呛咳的发生。
Objective To investigate the effect of dexmedetomidine on the indicators such as postoperative hemodyna-mics,stress response,and agitation in patients undergoing laparoscopic gastrectomy for gastric cancer under general anesthesia.Methods A total of 131 patients who underwent laparoscopic gastrectomy for gastric cancer in The Central Hospital of Enshi Autonomous Prefecture from January 2019 to December 2021 were enrolled as subjects,and they were divided into control group with 66 patients and observation group with 65 patients using a random number table.Both groups were given general anesthesia;the patients in the control group were given nalbuphine at 10 minutes before the end of surgery,and those in the observation group were given dexmedetomidine combined with nalbuphine.The two groups were compared in terms of heart rate,mean arterial pressure,biological indicators associated with stress response and inflammatory response,Sedation-Agitation Scale(SAS)score,agitation rate,and degree of bucking during tracheal extubation at the end of surgery(T_(0)),before tracheal extubation(T_(1)),imme-diately after tracheal extubation(T_(2)),at 5 minutes after tracheal extubation(T_(3)),and at 10 minutes after tracheal extubation(T_(4)).Results Compared with the control group,the observation group had significantly lower heart rate and mean arterial pressure at T_(1)and T_(2)(F=24.725-137.167,all P<0.05).At T_(2)and T_(4),the observation group had significantly lower blood glucose,cortisol,adrenaline,tumor necrosis factor-α,interleukin-6,and C-reactive protein than the control group(F=4.913-200.516,all P<0.05).Compared with the control group,the observation group had significantly lower SAS score,agitation rate,and degree of bucking during tracheal extubation(t=2.416,χ^(2)=5.715,Z=2.053,all P<0.05).Conclusion Dexmedetomidine can effectively attenuate postoperative hemodynamic fluctuation,alleviate stress and inflammation response,and reduce agitation and bucking during tracheal extubation in patients undergoing laparosco
作者
崔芝红
覃爱玲
朱贤林
CUI Zhihong;QIN Ailing;ZHU Xianlin(Department of Anesthesiology,the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi 445000,China)
出处
《青岛大学学报（医学版）》
CAS
2023年第4期568-571,共4页
Journal of Qingdao University(Medical Sciences)
基金
湖北省自然科学基金资助项目(2016CFB368)。
关键词
右美托咪啶
胃肿瘤
腹腔镜检查
纳布啡
血流动力学
应激
生理学
苏醒谵妄
咳嗽
dexmedetomidine
stomach neoplasms
laparoscopy
nalbuphine
hemodynamics
stress,physiological
emergence delirium
cough
