右美托咪定联合血必净对胃肠癌根治术后谵妄的影响  

Effect of Dexmedetomidine Combined with Xuebijing on Delirium After Radical Resection of Gastrointestinal Cancer

作　　者：李广伟 田玉红[1] 赵军[1] LI Guangwei;TIAN Yuhong;ZHAO Jun(Department of Anesthesiology,The Second Hospital of Qinhuangdao,Qinhuangdao,Hebei,China 066600)

机构地区：[1]河北省秦皇岛市第二医院麻醉科

出　　处：《中国药业》2019年第14期44-46,共3页China Pharmaceuticals

基　　金：河北省科技计划项目[142777125]

摘　　要：目的探讨右美托咪定联合血必净对胃肠癌根治术后谵妄的影响。方法选取医院2015年1月至2017年12月收治的胃肠癌根治术患者216例,随机分为常规麻醉组、右美托咪定组、血必净组和联合组,各54例。4组患者均予枸橼酸舒芬太尼注射液、丙泊酚乳状注射液、苯磺顺阿曲库铵,常规麻醉组患者麻醉诱导时加用等量0.9%氯化钠注射液,右美托咪定组患者加用盐酸右美托咪定注射液(1.0μg/kg,泵注20min),血必净组患者加用血必净注射液50mL静脉滴注,联合组患者加用盐酸右美托咪定注射液联合血必净注射液(两药用法分别同前)。结果常规麻醉组、血必净组、右美托咪定组、联合组患者术后3d白细胞介素6、肿瘤坏死因子-α及C反应蛋白均较术前显著升高,但各组指标水平依次降低,组间比较,差异有统计学意义(P<0.05);联合组、右美托咪定组术后6h,1d,3d,5d谵妄发生率显著低于常规麻醉组(P<0.05);4组患者术后不良反应发生率无显著差异(P>0.05)。结论右美托咪定联合血必净可显著降低胃肠癌根治术后谵妄发生率,降低炎性因子水平,且不增加不良反应。Objective To investigate the effect of dexmedetomidine combined with Xuebijing on delirium after radical resection of gastrointestinal cancer.Methods Totally 216 patients with gastrointestinal cancer admitted to our hospital from January 2015 to December 2017 were selected and randomly divided into routine anesthesia group,dexmedetomidine group,Xuebijing group and combination group,54 cases in each group.Sufentanil Citrate Injection,Propofol Emulsion Injection and cisatracurium besylate were given to all the patients in the 4 groups,on this basis,the patients in the routine anesthesia group were additionally given 0.9%Sodium Chloride Injection during induction of anesthesia,the patients in the dexmedetomidine group were additionally given Dexmedetomidine Hydrochloride Injection(1μg/kg,2 0 min by pump),the patients in the Xuebijing group were additionally given Xuebijing Injection(50 mL,intravenous drip),the patients in the combination group were additionally given Dexmedetomidine Hydrochloride Injection and Xuebijing Injection(the use of the two drugs was the same as before).Results On the 3rd day after operation,t he levels of interleukin-6,tumor necrosis factor-α(TNF-α)and C-reactive protein in routine anesthesia group,Xuebijing group,dexmedetomidine group and combination group were significantly higher than those before operation,but the levels of indexes in each group decreased in turn,and there was significant difference among the 4 groups(P<0.05).The incidence of delirium in the combination group and dexmedetomidine group was significantly lower than that in the routine anesthesia group at 6 h,1 d,3 d and 5 d after operation(P<0.05).There was no significant difference in the incidence of adverse reactions among the 4 groups(P>0.05).Conclusion Dextrometridine combined with Xuebijing can significantly reduce the incidence of delirium after radical resection of gastrointestinal cancer,reduce the level of inflammatory factors without increasing the adverse reactions.

关 键 词：右美托咪定 血必净 胃肠癌根治术 谵妄 炎性反应 

分 类 号：R969.4[医药卫生—药理学] R2-031[医药卫生—药学]