右美托咪定在胃癌根治术中的临床应用研究  

The Effect of Dexmedetomidine Hydrochloride in Radical Gastrectomy for Patients with Gastric Cancer

作　　者：于铁莉[1] 岳文慧[1] 王金城[2] 王志学[1] 李汝泓[1] 李艳[1] 张晓侠[1] 

机构地区：[1]承德医学院附属医院麻醉科,河北承德067000 [2]河北医科大学第三医院麻醉科,河北石家庄050013

出　　处：《河北医学》2014年第12期2006-2009,共4页Hebei Medicine

摘　　要：目的:观察不同剂量右美托咪定对胃癌根治术患者血流动力学及应激反应的影响。方法:选择90例全麻下行胃癌根治术的患者,随机分为三组(C、D1和D2组),每组30例。C组为对照组,给予等量生理盐水;D1、D2组为右美组,于麻醉诱导前10min内分别给予负荷剂量0.5μg/kg、0.8μg/kg,术中维持速度分别为0.5μg·kg-1·h-1、0.8μg·kg-1·h-1。记录三组病人:入室时(T0)、气管插管毕即刻(T1)、切皮时(T2)、进腹(T3)、手术开始后30min(T4)、术毕(T5)各时点心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、血浆皮质醇(Cor)和血糖(Glu)以及不良反应例数。结果:T1、T2、T3时点C组HR、SBP、DBP、MAP明显高于D1、D2组(P<0.05);T5时点C组的Cor、Clu浓度高于D1、D2组(P<0.05)。C组各时点血流动力学波动明显(P<0.05),而D1、D2组波动不大(P>0.05)。不良反应例数D2组多于D1组。结论:中等剂量右美0.5μg/kg更适用于胃癌根治术患者临床应用。Objective：To observe the effects of different doses of dexmedetomidineon on hemodynamics and stress reflect in radical gastrectomy for gastric cancer .Method：90 patients underwent radical operation for gastric cancer were subjected .They were divided into three groups randomly , 30 cases in each group （ group C,D1 and D2） .Group C was offered the same amount of physiological saline .Two test groups （ D1 and D2 ） was given 0.5μg/kg and 0.8μg/kg loading dose of dexmedetomidine within 10min before endotrachael intubation,while 0.5μg· kg-1 · h-1 and 0.8μg· kg-1 · h-1 was pumped with micropump during the opera-tion.The parameters of heart rate （HR）,systolic blood pressure （SBP）, diastolic blood pressure （DBP） and mean arterial pressure （ MAP ） were recorded in the following time ：just entering operating room （ before Dex be given）（T0）, immediately after intubation （T1）, skin incision （T2）, opening abdomen（T3）,30min after the start of the operation （T4）, end of the surgery（T5）.At T5 time corticosteroid （Cor） and glucose （ Glu） of the arterial blood were measured .And recorded the adverse reactions .Result： Group C compared with group D1 and D2 of hemodynamic has obviously statistical differences at the time of T 1,T2,T3（P 〈0. 05）, and Cor and Glu at T5 time, group C were higher than group D1 and D2 （P〈0.05）;The comparison of hemodynamic has obviously differences （ P〈0.05） within group C in each time , but there were little changes between group D1 and D2 （P 〉0.05）.The adverse reactions of group D2 were more than group D1.Conclu-sion：Middle dose of 0.5μg /kg dexmedetomidine is more suitable for the patients with gastric cancer .

关 键 词：右美托咪定 血流动力学 应激反应 血 糖 皮质醇 

分 类 号：R735.2[医药卫生—肿瘤]