摘要
目的探讨右美托咪定复合瑞芬太尼对食管癌根治术患者应激反应的影响。方法选择2021年3月至2023年3月周口市中心医院接诊的行食管癌根治术的患者90例,随机均分为对照组和观察组2组,每组45例。对照组采取瑞芬太尼静脉麻醉,观察组采用右美托咪定复合瑞芬太尼静脉麻醉。比较2组患者麻醉相关指标、应激反应相关指标及不良反应发生情况。结果与对照组比较,观察组瑞芬太尼使用剂量减少,苏醒时间、拔管时间均缩短(t=35.240,P<0.001;t=11.810,P<0.001;t=10.340,P<0.001)。观察组患者术后3 d血清促肾上腺皮质激素、皮质醇水平均低于对照组(t=7.622,P<0.001;t=4.467,P<0.001)。观察组不良反应发生率低于对照组( χ^( 2)=4.406,P=0.036)。结论右美托咪定复合瑞芬太尼减少了食管癌根治术患者麻醉药物的剂量,减轻了应激反应,且安全性高,具有较高的临床推广价值。
Objective To probe the effect of dexmedetomidine combined with remifentanil on stress response in patients undergoing radical resection for esophageal cancer.Methods A total of 90 patients admitted to Zhoukou Central Hospital from March 2021 to March 2023 who underwent radical resection for esophageal cancer were arbitrarily grouped into the control group(n=45)and the observation groups(n=45).Patients in the control group were given intravenous anesthesia with remifentanil,and patients in the observation group were given intravenous anesthesia with dexmedetomidine combined with remifentanil.The anesthesia-related indexes,immune function,stress response and toxicities were compared between the two groups.Results Compared with the control group,the dose of remifentanil in the observation group was prominently lessened,and the awakening and the extubation time were prominently cut down(t=35.240,P<0.001;t=11.810,P<0.001;t=10.340,P<0.001).Compared with the control group,the serum ACTH and COR levels in the observation group were dramatically lessened 3 days after operation(t=7.622,P<0.001;t=4.467,P<0.001).Compared with the control group,the adverse reaction rate in the observation group was prominently lessened( χ^( 2)=4.406,P=0.036).Conclusion Dexmedetomidine combined with remifentanil could lessen the dose of anesthetic drugs in patients undergoing radical resection of esophageal cancer,reduce the stress response,have high safety,and have high clinical promotion value.
作者
陈龙
谢宏伟
候俊峰
CHEN Long;XIE Hongwei;HOU Junfeng(Department of Anesthesiology,Zhoukou Central Hospital,Zhoukou 466000,China)
出处
《肿瘤基础与临床》
2024年第2期162-164,共3页
journal of basic and clinical oncology
关键词
食管癌根治术
麻醉
右美托咪定
瑞芬太尼
血流动力学
应激反应
radical resection of esophageal carcinoma
anesthesia
dexmedetomidine
remifentanil
hemodynamics
stress response
