盐酸右美托咪定对老年患者胃癌根治手术后功能恢复的影响  

Effect of dexmedetomidine hydrochloride on functional recovery of elderly patients after radical gastrectomy for gastric cancer

作　　者：金建文[1] 刘俊乐[2] 卢斌 JIN Jianwen;LIU Junle;LU Bin(School of Medicine,Fujian Health College,Fujian,Fuzhou 350101,China;Department of Anesthesiology,Union Hospital,Fujian Medical University,Fujian,Fuzhou 350001,China;Department of Anesthesiology,Chang'an District Hospital of Xi'an,Shaanxi,Xi'an 710100,China)

机构地区：[1]福建卫生职业技术学院医学系,福建福州350101 [2]福建医科大学附属协和医院麻醉科,福建福州350001 [3]西安市长安区医院麻醉科,陕西西安710100

出　　处：《中国医药科学》2021年第4期91-94,101,共5页China Medicine And Pharmacy

摘　　要：目的观察盐酸右美托咪定对老年患者腹腔镜胃癌术后功能恢复的影响。方法选取2014年1月至2017年12月在西安市长安区医院普外科行腹腔镜胃癌根治术的老年患者80例,随机分为右美托咪定组(Dex组)和对照组(Con组)。Dex组患者入室麻醉前15 min静脉给予盐酸右美托咪定1μg/kg,而后静脉维持0.4μg/(kg·h),术前30 min停用盐酸右美托咪定;Con组相同时间点给予相同容量的生理盐水。术中两组患者均采用全凭静脉复合硬膜外麻醉,脑电双频指数(BIS)维持麻醉深度为40~60,术后多模式镇痛。比较两组患者麻醉药用量、住院时间、住院费用、炎症反应指标;术后功能恢复情况(PQRS),包括生命体征、情感、伤害性刺激、日常生活能力及认知功能。结果Dex组患者麻醉药用量、住院时间及住院费用均少于Con组(P<0.05);与Con组相比,Dex组患者围术期炎症指标[血沉(ESR),白介素-6(IL-6)],差异有统计学意义(P<0.05),而C反应蛋白(CRP)及中性粒细胞百分比,差异无统计学意义(P>0.05);两组患者术后功能恢复差异有统计学意义(P<0.05)。结论盐酸右美托咪定能明显减少围术期麻醉药用量,减少住院时间和费用,患者有更快更好的术后功能恢复。Objective To observe the effect of dexmedetomidine hydrochloride on postoperative functional recovery of elderly patients with laparoscopic gastric cancer.Methods A totaol of 80 elderly patients who underwent laparoscopic radical gastrectomy in general surgery department of Chang'an District Hospital of Xi'an from January 2014 to December 2017 were randomly divided into the dexmedetomidine group(Dex group)and the control group(Con group).Dex group was given dexmedetomidine hydrochloride of 1μg/kg intravenously 15 min before anesthesia,and then given dexmedetomidine hydrochloride of 0.4μg/(kg·h)intravenously,and dexmedetomidine hydrochloride was withdrawn 30 min before surgery.Con group was given the same volume of normal saline at the same time point.During the operation,patients in both groups were given total intravenous epidural anesthesia,and a bispectral index(BIS)range of 40-60 was maintained,and postoperative multi-mode analgesia was adopted.The anesthetic dosage,hospitalization time,hospitalization cost and inflammatory reaction index of the two groups were compared.Postoperative functional recovery(PQRS),including vital signs,emotion,noxious stimulation,activities of daily living and cognitive function were observed.Results The dosage of anesthetics,hospitalization stay and hospitalization expenses in Dex group were lower than those in Con group(P<0.05).Compared with Con group,the perioperative inflammation index(ESR and IL-6)in Dex group was significantly different(P<0.05),while CRP and neutrophil percentage were not significantly different(P>0.05).There was significant difference in functional recovery between the two groups(P<0.05).Conclusion Dexmedetomidine hydrochloride can significantly reduce the amount of anesthetic used in perioperative period,reduce the hospitalization time and cost,and promote the functional recovery in a faster and better manner after operation.

关 键 词：盐酸右美托咪定 老年患者 术后多模式镇痛 术后加速康复 炎症 

分 类 号：R735.2[医药卫生—肿瘤]