右美托咪啶复合麻醉对结肠癌根治术患者术中血流动力学及术后氧化应激和肠道屏障功能的影响  

Effects of dexmedetomidine combined anesthesia on hemodynamics,oxidative stress and intestinal barrier function in patients undergoing radical resection of colon cancer

作　　者：王淑辉 刘丽波[1] 叶苗青 Wang Shuhui;Liu libo;Ye Miaoging(Department of Gastroenterology,the 981 Hospital of the Joint Support Force of the Chinese People's Libera-tiom Army,Chengde 067000,China;Department of Hepatology,Shaanai Prouincial Hospital of Traditional Chinese Medicine.Ni'an 710003,China)

机构地区：[1]中国人民解放军联勤保障部队第九八一医院消化内科,承德067000 [2]陕西省中医医院肝病科,西安710003

出　　处：《中国医师杂志》2020年第12期1778-1781,共4页Journal of Chinese Physician

摘　　要：目的探讨右美托咪啶复合麻醉对结肠癌根治术患者术中血流动力学指标及术后氧化应激和肠道屏障功能的影响。方法选取2018年6月至2020年9月在第九八一医院行结肠癌根治术的96例患者作为研究对象,采用随机数字表法分为对照组和观察组,每组各48例。两组均行结肠癌根治术,对照组采用常规静脉吸入复合麻醉,观察组在此基础上加用右美托咪啶复合麻醉比较两组患者血流动力学指标、认知功能障碍情况、氧化应激和肠道屏障功能。结果气管插管后1 min(T1)、拔管时(T2),两组心率(HR)、收缩压(SBP)、舒张压(DBP)水平均高于麻醉诱导前(T0),且观察组HR,SBP,DBP水平均低于对照组(P<0.05),术后24 h,两组简易精神状态量表(MMSE)评外均低于术前,S100gB蛋白、神经元特异性烯醇化酶(NSE)水平均高于术前,且观察组MMSE评分高于对照组,S100p蛋白,NSE水平均低于对照组(P<0.05)。术后24 h,两组丙二醛(MDA)水平均高于术前,超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)及总抗氧化态(TAS)水平均低于术前,且观察组MDA水平低于对照组,50D.GSH-Px,TAS水平均高于对照组(P<0.05)。术后7d.两组二胺氧化酶(DAO).D-乳酸、内毒素水平均低于术前,且观察组DA0,D-乳酸、内毒素水平均低于对照组(P<0.05)。结论右美托咪啶复合麻醉应用于结肠癌根治术,能够有效降低血流动力学反应和认知功能损伤,减轻氧化应激反应,改善肠道屏障功能,有利于改善患者预后,值得推广。Objective To investigate the effeets of dexmedetomidine combined anesthesia on intraoperative hemodynamie indexes,postoperative oxidative stress and intestinal barrier function in patients undergoing radical resection of colon cancer.Methods 96 patients who underwent radical resection of colon cancer in The 981 Hospital from June 2018 to September 2020 were selected as the research objects,and they were divided into the control group(n=48)and the observation group(n=48)using random number table method.Both groups undervent radical resection of colon cancer.The control group received conventional intravenous inhalation combined anesthesia,and the observation group received dexmedetomidine combined anesthesia on this basis.The hemodvnamic indicators.cognitive dysfunction.oxidative stress and intestinal barrier funetion were compared between the two groups.Results At 1 min after tracheal intubation(T1)and extubation(T2),the levels of heart rate(HR),svstolic blood pressure(SBP)and diastolie blood pressure(DBP)in the two groups were higher than those before anesthesia induction(T0),and the levels of HR,SBP and DBP in the observation group were lower than those in the control group(P<0.05).24 hours after operation,the scores of Mini Mental State Scale(MMSE)in the two groups were lower than those before operation,and the levels of S100 B protein and neuron specific enolase(NSE)were higher than those before operation;the MMSE score of observation group was higher than that of control group,and the levels of S100 B protein and NSE were lower than those of control group(P<0.05).24 hours after operation,the levels of malondialdehvde(MDA)in the two groups were higher than those before operation,and the levels of superoxide dismutase(SOD).glutathione peroxidase(GSH-Px)and total antioxidant state(TAS)were lower than those before operation;the levels of MDA inthe observation group were lower than those in the control group,and the levels of SOD,GSH-Px and TAS in the observation group were higher than those in the control group(

关 键 词：结肠肿瘤 右美托咪啶 麻醉 血流动力学 氧化性应激 

分 类 号：R614[医药卫生—麻醉学] R735.35[医药卫生—外科学]