右美托咪定联合七氟醚对老年患者腹腔镜下胃肠肿瘤切除术后血流动力学、认知功能及谵妄的影响  

Effects of dexmedetomidine combined with sevoflurane on hemodynamics,cognitive function and delirium of elderly patients undergoing laparoscopic gastrointestinal tumor resection

作　　者：何勇[1] 丁颖[1] 朱俊杰[1] 何亮[1] HE Yong;DING Ying;ZHU Junjie;HE Liang(Department of Anesthesiology,the Second Affiliated Hospital of Nanjing Medical University,Nanjing,210011,Jiangsu,China)

机构地区：[1]南京医科大学第二附属医院麻醉科,江苏南京210011

出　　处：《肿瘤药学》2022年第3期396-399,共4页Anti-Tumor Pharmacy

摘　　要：目的探究右美托咪定对老年腹腔镜下胃肠肿瘤切除术患者的作用效果。方法选择2017年6月—2018年5月我院收治的择期行腹腔镜下胃肠肿瘤切除术患者80例为研究对象,按照随机数字表法分为观察组(n=40)和对照组(n=40)。对照组采用七氟醚麻醉,观察组在对照组的基础上加用右美托咪定麻醉,比较两组患者在五个不同时刻[术前(T_(0))、右美托咪定泵注10 min后(T_(1))、气管插管后即刻(T_(2))、气腹时(T_(3))、气管拔管后即刻(T_(4))]的平均动脉压(MAP)、心率(HR)、简易智力状态检查量表(MMSE)评分以及术后谵妄的发生率。结果T_(1)、T_(2)、T_(3)、T_(4)时刻,观察组患者MAP、HR均明显低于对照组(P<0.05);术后两组患者MMSE评分均明显低于术前(P<0.05),但观察组明显高于对照组(P<0.05);观察组患者术后谵妄的发生率明显低于对照组(P<0.05)。结论右美托咪定能有效稳定老年腹腔镜胃肠肿瘤切除术患者的血流动力学指标,减少认知功能障碍和谵妄的发生。Objective To explore the effects of dexmedetomidine on elderly patients undergoing laparoscopic gastrointestinal tumor resection.Methods A total of 80 patients who got laparoscopic gastrointestinal tumor resection between Jun.2017 and May 2018 were selected in this study.They were divided into observation group(n=40)and control group(n=40)according to the random number table method.The control group was anesthetized with sevoflurane,while the observation group was anesthetized with sevoflurane plus dexmedetomidine.The mean arterial pressure(MAP),heart rate(HR)at five time points during operation[preoperative(T_(0)),10 min after pumping dexmedetomidine(T_(1)),immediately after tracheal intubation(T_(2)),pneumoperitoneum(T_(3)),and immediately after tracheal extubation(T_(4))].The scores of mini-mental state examination scale(MMSE)before and after operation and the incidence of delirium after operation were also compared between the two groups.Results At the time of T_(1)、T_(2)、T_(3) and T_(4),the MAP and HR were significantly lower in the observation group than in the control group(P<0.05).The MMSE score of the two groups after operation was significantly lower than before operation(P<0.05).But after operation,the MMSE score of the observation group was significantly higher than that of the control group(P<0.05).The incidence of delirium after operation was significantly lower in the observation group than in the control group(P<0.05).Conclusion Dexmedetomidine can effectively stabilize the hemodynamic parameters and reduce the incidence of cognitive dysfunction and delirium of elderly patients undergoing laparoscopic gastrointestinal tumor resection.

关 键 词：右美托咪定 腹腔镜 胃肠肿瘤切除术 血流动力学 

分 类 号：R735.2[医药卫生—肿瘤] R735.3[医药卫生—临床医学]