右美托咪定对采用Trendelenburg体位的宫颈癌老年患者围手术期的影响研究  

Effect of dexmedetomidine on perioperative period of elderly patients with cervical cancer in Trendelenburg position

作　　者：段佳琪 黄厚刚[1] 税春玲[1] 罗希[1] 江伟[1] DUAN Jiaqi;HUANG Hougang;SHUI Chunling;LUO Xi;JIANG Wei(Department of Anesthesiology,Yongchuan Hospital of Chongqing Medical University,Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院麻醉科,重庆永川402160

出　　处：《现代医药卫生》2021年第5期728-731,共4页Journal of Modern Medicine & Health

基　　金：重庆市永川区科学技术委员会医学科研项目(Ycstc,2015nc50002);重庆医科大学附属永川医院研究生创新基金项目(YJSCX201911)。

摘　　要：目的探讨右美托咪定对采用Trendelenburg体位(以下简称T位)的宫颈癌老年患者围手术期的影响。方法选取2019年3—12月该院确诊为宫颈癌的老年患者70例,按随机数字表法将其分为对照组和观察组,各35例。比较2组不同时间点心率(HR)、平均动脉压(MAP)、肿瘤坏死因子α(TNF-α)、白细胞介素(IL)6、IL-1β及C反应蛋白(CRP)水平,以及术后拔管时间、住院时间及不良反应发生率。结果观察组术后拔管时间和住院时间显著低于对照组,差异均有统计学意义(P<0.05)。2组除入室时外其他各时间点HR、MAP水平比较,差异均有统计学意义(P<0.05)。2组术毕及术后24 h时血清TNF-α、IL-6、IL-1β及CRP水平比较,差异均有统计学意义(P<0.05)。对照组不良反应发生率高于观察组,差异有统计学意义(P<0.05)。结论右美托咪定可减轻采用T位的宫颈癌老年患者围手术期炎性反应,具有良好血流动力学稳定性,有利于改善患者预后。Objective To investigate the effect of dexmedetomidine on the perioperative period of elderly patients with cervical cancer in the Trendelenburg position(T position).Methods 70 elderly patients with cervical cancer diagnosed in the hospital from March to December 2019 were randomly divided into control group and observation group,35 cases in each group.The fasting rate(HR),mean arterial pressure(MAP),tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-1βand C-reactive protein(CRP)levels were compared between the two groups at different time points,as well as the extubation time,hospitalization time and incidence of adverse reactions after operation.Results The extubation time and hospitalization time in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).There were significant differences in HR and MAP levels between the two groups at other time points except at the time of entering the room(P<0.05).There were significant differences in serum TNF-α,IL-6,IL-1βand CRP levels between the two groups at the end of operation and 24 h after operation(P<0.05).The incidence of adverse reactions in the control group was higher than that in the observation group,and the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine can reduce the inflammatory reaction in the perioperative period of elderly patients with cervical cancer in the T position,and has good hemodynamic stability,which is conducive to improve the prognosis of patients.

关 键 词：右美托咪定 Trendelenburg体位 宫颈癌 血流动力学 炎性因子 

分 类 号：R541.4[医药卫生—心血管疾病]