右美托咪定对行腹腔镜恶性肿瘤根治术患者术后肾功能的影响  

Effect of dexmedetomidine on postoperative renal function of patients with malignant tumors undergoing laparoscopic radical dissection

作　　者：赵添寿[1] 

机构地区：[1]广西中医药大学附属瑞康医院麻醉科,南宁市530011

出　　处：《广西医学》2017年第6期822-824,共3页Guangxi Medical Journal

摘　　要：目的观察右美托咪定对行腹腔镜下恶性肿瘤根治术的患者术后肾功能的影响。方法选择择期行腹腔镜恶性肿瘤根治术的患者44例,按随机数字表法分为右美托咪定组和对照组,每组22例。两组患者麻醉诱导、麻醉维持用药相同,右美托咪定组在麻醉诱导时静脉泵注右美托咪定而对照组给予等容量的生理盐水。观察两组患者术前(T_1)、术毕(T_2)、术后第1天(T_3)、术后第3天(T_4)血肌酐(SCr)、尿素氮(BUN)、胱抑素C(Cys-C)水平。结果两组SCr、BUN水平比较,差异无统计学意义(P>0.05);各组内各时点SCr水平比较差异无统计学意义(P均>0.05),但各组内各时点BUN水平比较,差异有统计学意义(P<0.05),其中T_3时BUN水平低于其他时点。与T_1时比较,T_2~T_4时两组的Cys-C水平明显增高(P<0.05);T_2~T_4时右美托咪定组Cys-C水平明显低于对照组(P<0.05)。结论麻醉时静脉泵注右美托咪定对腹腔镜恶性肿瘤根治术患者术后肾功能具有一定的保护作用。Objective To observe the effect of dexmedetomidine on the postoperative renal function of patients with malignant tumors undergoing laparoscopic radical dissection. Methods Forty-four patients with malignant tumors undergoing selective laparoscopic radical dissection were divided into dexmedetomidine group and control group using random number table,with 22 cases in each group. The same induction and maintenance of anesthesia were performed in both groups. During the anesthesia induction,intravenous pumping of dexmedetomidine was performed in the dexmedetomidine group,and the equal volume of normal saline was given in the control group.Before surgery（ T1）,at the end of surgery（ T2）,on the first day after surgery（ T3） and the third day after surgery（ T4）,the levels of serum creatinine（ SCr）,blood urea nitrogen（ BUN） and cystatin C（ Cys-C） were observed. Results There were no statistically significant differences in the levels of SCr or BUN between the two groups（ P〈0. 05）. No statistically significant difference was found in the SCr level among all time points in any group（ P〈0. 05）. But there was statistical difference in BUN level among all time points in each group（ P〈0. 05）,and the BUN level at T3 was lower than those at the other time points. Compared with the level at T1,the Cys-C level increased significantly at T2-T4 in both groups（ P〈0. 05）. At T2-T4,the Cys-C levels in the dexmedetomidine group were significantly lower than those in the control group（ P〈0. 05）.Conclusion Intravenous pumping of dexmedetomidine during anesthesia might have some protective effects on the postoperative renal function of patients with malignant tumors undergoing laparoscopic radical dissection.

关 键 词：恶性肿瘤 根治术 腹腔镜 麻醉 右美托咪定 肾功能 

分 类 号：R735[医药卫生—肿瘤]