盐酸右美托咪啶在老年患者腹腔镜结直肠癌根治术麻醉中的应用研究  

The Application of Dexmetomidine Hydrochloride Inanaes the Ticprocess of Laparoscopic Colorectal Cancer in Elderly Patients

作　　者：刘新法[1] 张杰[1] 谢国柱[1] 高永涛[2] LIU Xinfa;ZHANG Jie;XIE Guozhu;GAO Yongtao(Anesthesiology Department, Taizhou People’s Hospital/ No.5 Affiliated Hospital of Nantong University, Taizhou, Jiangsu,225300, China;Anesthesiology Department, Nantong University Hospital, Nantong, Jiangsu, 226001, China)

机构地区：[1]泰州市人民医院/南通大学第五附属医院麻醉科,江苏泰州225300 [2]南通大学附属医院麻醉科,江苏南通226001

出　　处：《肿瘤药学》2017年第6期739-742,共4页Anti-Tumor Pharmacy

基　　金：江苏省自然科学基金(No.BK20140222)

摘　　要：目的探讨盐酸右美托咪啶在老年患者腹腔镜结直肠癌根治术麻醉中的应用研究。方法选取2014年2月~2017年2月我院收治的腹腔镜结直肠癌根治术患者96例,随机分为两组,对照组麻醉诱导前应用生理盐水,研究组应用盐酸右美托咪啶,对比两组患者的麻醉效果及术后认知功能障碍(POCD)发生情况。结果两组患者手术指标对比方面,研究组患者的手术时间、出血量、清醒时间以及拔管时间显著低于对照组(P<0.05);手术前两组患者的神经元烯醇化酶(NSE)、S100β蛋白以及肿瘤坏死因子-α(TNF-α)水平无明显差异(P>0.05),手术后研究组均显著低于对照组(P<0.05);手术前两组患者的简易智力检查量表(MMSE)评分无明显区别(P>0.05),手术后各个时间点研究组均显著高于对照组(P<0.05);术后认知功能障碍发生情况方面,研究组患者发生率显著低于对照组(P<0.05)。结论腹腔镜结直肠癌根治术患者应用盐酸右美托咪啶,有利于降低POCD发生风险,值得临床推广应用。Objective To investigate the effects of dexmedetomidine hydrochloride in laparoscopic colorectal cancer radical surgery anesthesia and effect on the incidence of postoperative cognitive dysfunction.Methods96patients with colorectal cancer bylaparoscopicradical surgery were selected in our hospital from February2014to February2017,they were randomly divided into two groups,48cases for each group.The patients in control group were given normal saline before induction of anesthesia,while the patients in the study group were given dexmedetomidine hydrochloridebefore induction of anesthesia,postoperative cognitive function disorder incidence of patients by anesthesia were compared between the two groups.Results The operation time,blood loss,recovery time and extubation time of patients in study group were significantly lower than that in the control group.(P<0.05);the NSE,S100protein and TNF-alpha(TNF alpha)the levels of patients hadno significant difference before surgerybetween the two groups(P>0.05),they were significantly lower than that in control group after treatment(P<0.05);the MMSE score of patients had no significant difference between the two groups before treatment(P>0.05),it was were significantly higherin study group than control groupafter surgery at different time points(P<0.05);the incidence ofpostoperative cognitive dysfunction of patients in the study group was significantly lower than that in the control group(P<0.05).Conclusion The application of dexmedetomidine hydrochloride in laparoscopic radical resection of colorectal cancer is beneficial to reduce the risk of POCD,and it should be popularized in clinical practice.

关 键 词：盐酸右美托咪啶 腹腔镜 结直肠癌根治术 术后认知功能障碍 

分 类 号：R735.3[医药卫生—肿瘤]