小剂量右美托咪定对腹腔镜远端胃癌根治术患者术后应激反应和谵妄的影响  

Effects of low--dose Dexmedetomidine on postoperative stress response and delirium in patients underg-oing laparoscopic distal gastrectomy for gastric cancer

作　　者：罗琦珑[1] 余红梅[2] 李娜[1] 董金莲[1] LUO Qi-long;YU Hong-mei;LI Na;DONG Jin-lian(Department of Anesthesiology, the First People's Hospital of Yichang, Hubei, Yichang 443000, China;Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China)

机构地区：[1]宜昌市第一人民医院三峡大学人民医院麻醉科,湖北宜昌443000 [2]浙江大学医学院附属邵逸夫医院普通外科,杭州310016

出　　处：《中国医学前沿杂志（电子版）》2017年第6期87-90,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：浙江省卫生厅项目(2015116990)

摘　　要：目的探讨小剂量右美托咪定对腹腔镜远端胃癌根治术患者术后应激反应和谵妄的影响。方法将2016年1月至2016年12月本院收治的胃癌患者80例随机分为观察组和对照组,每组各40例,两组患者均在全身麻醉下行腹腔镜远端胃癌根治术,观察组患者同时给予小剂量右美托咪定,观察并比较两组患者手术情况、术后情况、术后应激反应指标水平变化、谵妄发生率及并发症发生情况。结果两组患者尿量、术中总静脉补液量、手术时间、术中出血量、淋巴结清扫数目及并发症发生率比较均无显著差异(P>0.05)。术后24小时,观察组患者C反应蛋白、血管紧张素Ⅱ及肾上腺素水平均显著低于对照组(P<0.05)。观察组患者术后谵妄发生率显著低于对照组(P<0.05),术后肛门排气时间和住院天数均显著短于对照组(P<0.05)。结论小剂量右美托咪定可能有助于降低腹腔镜远端胃癌根治术患者术后应激反应和谵妄发生率。Objective To investigate the effects of low-dose Dexmedetomidine on postoperative stress response and delirium in patients undergoing laparoscopic distal gastrectomy for gastric cancer.Method80patients suffered from laparoscopic distal gastrectomy for gastric cancer from January2016to December2016in our hospital were randomly assigned into observation group and control group,40cases in each group.Under the general anesthesia,all patients received laparoscopic distal gastrectomy for gastric cancer.And during the operation,low-dose Dexmedetomidine was given to observation group patients.The operation condition,postoperative condition,postoperative stress response indexes levels changes,incidence of delirium and complications incidence rates were compared between the two groups.Result There were no significant differences in urine volume,intraoperative total fluid volume,operation time,intraoperative blood loss,the number of lymph node dissection and the incidence of complications between the two groups(P>0.05).24hours after operation,the levels of ngiotensinⅡ,C reactive protein and adrenaline in observation group were significantly lower than those in control group(P<0.05).The incidence of postoperative delirium of observation group was significantly lower than that of control group(P<0.05),the postoperative anal exhaust time and hospital day were significantly shorter than those in control group(P<0.05).Conclusion Low-dose Dexmedetomidine may reduce the incidence of postoperative stress response and delirium in patients undergoing laparoscopic distal gastrectomy for gastric cancer.

关 键 词：右美托咪定 腹腔镜 远端胃癌根治术 应激反应 谵妄 

分 类 号：R614[医药卫生—麻醉学] R735.2[医药卫生—外科学]