右美托咪定辅助麻醉对老年结肠癌根治术患者血流动力学及术后认知功能的影响研究  

Study on the effects of dexmedetomidine-assisted anesthesia on hemodynamics and postoperative cognitive function in elderly patients undergoing radical surgery of colon cancer

作　　者：宁素梅[1] NING Sumei(Department of Anesthesia,Beihai People′s Hospital in Guangxi Zhuang Autonomous Region,Beihai 536000,China)

机构地区：[1]广西壮族自治区北海市人民医院麻醉科,广西北海536000

出　　处：《中国现代医生》2022年第11期140-143,共4页China Modern Doctor

摘　　要：目的探讨对采用结肠癌根治术治疗的老年患者采用右美托咪定辅助麻醉的临床效果。方法选取2018年1月至2021年5月广西壮族自治区北海市人民医院收治的76例择期行腹腔镜结肠癌根治术治疗的患者为研究对象,采用随机排列法分为对照组和观察组,每组各38例。其中观察组在麻醉诱导前以1μg/kg的剂量静脉泵入右美托咪定,麻醉诱导后再以每小时0.5μg/kg维持泵入;而对照组则以同等方式泵入等剂量的生理盐水。比较两组入手术室时(T_(0))、插管前1 min(T_(1))、插管过程中(T_(2))、插管后1 min(T_(3))、手术结束时(T_(4))、拔管后1 min(T_(5))以及离开麻醉恢复室时(T_(6))心率(HR)和平均动脉压(MAP)的变化,对比手术前1 d、手术后1 d和手术后3 d两组患者的认知功能。结果观察组苏醒时间(20.64±3.88)min、自主呼吸恢复时间(4.75±0.61)min、首次排气时间(5.75±1.06)h和肠鸣音恢复时间(19.30±4.21)h均短于对照组的(35.42±3.71)min、(12.54±2.33)min、(8.86±1.23)h和(28.94±5.72)h(P<0.05)。观察组在T_(0)阶段HR和MAP水平与对照组相比,差异无统计学意义(P>0.05);但在T_(1)~T_(6)阶段,观察组HR和MAP水平均低于对照组(P<0.05)。观察组术前1 d MMSE评分与对照组相比,差异无统计学意义(P>0.05);观察组术后1 d和术后3 d MMSE评分为(27.01±0.38)分、(28.99±0.42)分,均高于对照组的(24.79±0.35)分、(26.91±0.41)分(P<0.05)。结论对腹腔镜结肠癌根治术治疗的老年患者采用右美托咪定辅助麻醉可以在不影响血流动力学的同时减轻患者术后认知功能障碍的情况,促进患者术后尽早恢复,临床应用效果显著。Objective To explore the clinical effects of dexmedetomidine-assisted anesthesia on elderly patients undergoing radical surgery of colon cancer.Methods A total of 76 patients admitted to Beihai People’s Hospital for elective laparoscopic radical surgery of colon cancer from January 2018 to May 2021 were selected as study subjects and divided into the control group and the observation group using random arrangement method,with 38 patients in each group.Patients in the observation group were intravenously pumped dexmedetomidine at a dose of 1μg/kg before induction of anesthesia and then the pumping was maintained at 0.5μg/kg per hour after the completion of induction,while patients in the control group were pumped equal doses of normal saline in the same manner.The changes in heart rate(HR)and mean arterial pressure(MAP)at the time of admission to the operating room(T_(0)),1 minute before intubation(T_(1)),during intubation(T_(2)),1 minute after intubation(T_(3)),at the end of surgery(T_(4)),1 minute after extubation(T_(5)),and at the time of leaving the anesthesia recovery room(T_(6))were compared between the two groups,and the cognitive function of patients was also compared between the two groups at 1 day before surgery,and 1 day and 3 days after surgery.Results The awakening time was(20.64±3.88)min,recovery time of spontaneous respiration was(4.75±0.61)min,time to first exhaustion was(5.75±1.06)h and recovery time of borborygmus was(19.30±4.21)h in the observation group,which were shorter than those of(35.42±3.71)min,(12.54±2.33)min,(8.86±1.23)h and(28.94±5.72)h in the control group(P<0.05).There were no significant differences between the observation group and the control group in HR and MAP levels at T_(0)(P>0.05);however,HR and MAP levels in the observation group were lower than those in the control group from T_(1) to T_(6)(P<0.05).There was no significant difference between the observation group and the control group in the cognitive function scores 1 day before surgery(P>0.05);however,the cogn

关 键 词：结肠癌根治术 老年人 右美托咪定 血流动力学 认知功能 术后恢复情况 

分 类 号：R614.2[医药卫生—麻醉学]