右美托咪定对食管癌患者术中脑血氧饱和度及术后认知功能障碍的影响  

Effects of dexmedetomidine on intraoperative cerebral oxygen saturation and postoperative cognitive dysfunction in patients with esophageal cancer

作　　者：刘一丹 刘亚华[1] 姜莉莉[1] 刘艳萍[1] LIU Yidan;LIU Yahua;JIANG Lili;LIU Yanping(Department of Anesthesiology,Affiliated Tumor Hospital,Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学附属肿瘤医院麻醉与围术期医学中心,乌鲁木齐830011

出　　处：《新疆医科大学学报》2022年第12期1443-1447,共5页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区自然科学基金(2019D01C250)。

摘　　要：目的 探讨右美托咪定对食管癌患者术中脑血氧饱和度及术后认知功能障碍风险的影响。方法 纳入2020年2月至2021年12月新疆医科大学附属肿瘤医院拟行食管癌根治术的70例患者,采用随机数字表法分为右美托咪定组和对照组,每组35例。对照组予以常规麻醉,右美托咪定组在对照组的基础上予以右美托咪定麻醉。比较两组患者术中患者脑血氧饱和度、麻醉深度,记录两组患者术中阿片类药物需求量情况,比较两组患者术后认知功能评分及认知功能障碍发生率情况。结果 右美托咪定组患者T1、T2、T3及T4时脑血氧饱和度均高于对照组(P<0.05);右美托咪定组患者T1、T2、T3及T4时双频指数(BIS)低于对照组(P<0.05);右美托咪定组患者T4、T5、T8及T7时认知功能评分均高于对照组(P<0.05);右美托咪定组术中瑞芬太尼、舒芬太尼累积剂量低于对照组(P<0.05);两组认知功能障碍发生率差异无统计学意义(P>0.05)。结论 右美托咪定可有效维持食管癌患者术中脑血氧饱和度,提高麻醉深度,降低患者术中阿片类药物需求量,对患者认知功能损伤小。Objective To investigate the effect of dexmedetomidine on intraoperative cerebral oxygen saturation and the risk of postoperative cognitive dysfunction in patients with esophageal cancer. Methods From February 2020 to December 2021, 70 patients in the hospital who were going to undergo radical resection for esophageal cancer were included and divided into the dexmedetomidine group and the control group by random number table method, with 35cases in each group. The control group was given routine anesthesia, and the dexmedetomidine group was given dexmedetomidine anesthesia on the basis of the control group. The intraoperative cerebral oxygen saturation and depth of anesthesia of the two groups of the patients were compared;the intraoperative opioid requirements of the two groups were recorded;and the postoperative cognitive function scores and the incidence of cognitive dysfunction were compared between the two groups. Results The cerebral blood oxygen saturation at T1, T2, T3 and T4 in the dexmedetomidine group was higher than that in the control group(P<0. 05);anesthesia depth index(Bispectral Index,BIS) in the dexmedetomidine group was lower than that in the control group at T1, T2, T3 and T4(P<0. 05);the cognitive function scores at T4, T5, T8 and T7 in the dexmedetomidine group were higher than those in the control group(P<0. 05);intraoperative cumulative doses of remifentanil and sufentanil in the dexmedetomidine group was lower than the control group(P<0. 05);and there was no significant difference in the incidence of cognitive impairment between the groups(P>0. 05). Conclusion Dexmedetomidine in patients with esophageal cancer surgery can effectively maintain intraoperative cerebral blood oxygen saturation, increase the depth of anesthesia, reduce intraoperative opioid requirements, and reduce patients’ cognitive impairment.

关 键 词：右美托咪定 食管癌 脑血氧饱和度 认知功能障碍 

分 类 号：R614[医药卫生—麻醉学]