右美托咪定联合纳布啡在腹腔镜胃癌根治术患者中的应用效果  

Application effect of dexmedetomidine combined nalbuphine in patients with laparoscopic radical gastrectomy

作　　者：周华 蒋亚坤 张占军[1] 李玮宇 ZHOU Hua;JIANG Yakun;ZHANG Zhanjun;LI Weiyu(Anesthesia and Surgery Center,Jiaozuo People’s Hospital,Jiaozuo 454001,He’nan,China;Department of Gastrointestinal Surgery,Jiaozuo People’s Hospital,Jiaozuo 454001,He’nan,China)

机构地区：[1]焦作市人民医院麻醉手术中心,河南焦作454001 [2]焦作市人民医院胃肠外科,河南焦作454001

出　　处：《癌症进展》2023年第3期338-341,共4页Oncology Progress

摘　　要：目的探讨右美托咪定联合纳布啡在腹腔镜胃癌根治术患者中的应用效果。方法根据镇痛方法的不同将86例接受全身麻醉的腹腔镜胃癌根治术患者分为对照组(n=43,采用纳布啡)和观察组(n=43,采用右美托咪定联合纳布啡)。比较两组患者的疼痛程度[视觉模拟评分法(VAS)]、苏醒期躁动情况、炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)]水平及谵妄发生情况。结果术后2、8、32、48 h,两组患者运动状态下VAS评分均低于本组术前,且观察组患者的VAS评分均低于对照组,差异均有统计学意义(P<0.05)。术后8、32、48 h,两组患者静息状态下VAS评分均低于本组术前,且观察组患者VAS评分均低于对照组,差异均有统计学意义(P<0.05)。观察组患者苏醒期躁动发生率为6.98%,低于对照组患者的27.91%(P<0.05)。术后2、8、32、48 h,两组患者CRP、IL-6、TNF-α水平均高于本组术前,观察组患者CRP、IL-6、TNF-α水平均低于对照组,差异均有统计学意义(P<0.05)。观察组患者谵妄发生率为4.65%,低于对照组患者的20.93%(P<0.05)。结论针对接受腹腔镜胃癌根治术并进行全身麻醉的患者,联合应用右美托咪定和纳布啡进行镇痛,不仅能够缓解疼痛,还能减轻炎症反应,有助于改善患者预后。Objective To explore the effect of dexmedetomidine combined nalbuphine in patients with laparoscopic radical gastrectomy.Method According to different analgesic methods,86 patients undergoing laparoscopic radical gastrectomy and general anesthesia were divided into control group(n=43,received nalbuphine)and observation group(n=43,received dexmedetomidine+nalbuphine).The pain degree[visual analogue scale(VAS)],agitation during recovery,inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)]levels,and delirium were compared between the two groups.Result The VAS scores during exercise state at 2,8,32,and 48 hours after operation in both groups were lower than those before operation,with lower scores in the observation group than those in the control group(P<0.05).The VAS scores during rest state at 8,32,and 48 hours after operation in both groups were lower than those before operation,with lower scores in the observation group than those in the control group(P<0.05).The incidence of agitation during recovery in the observation group was 6.98%,lower than 27.91%in the control group(P<0.05).The levels of CRP,IL-6 and TNF-αin both groups at 2,8,32 and 48 hours after operation were significantly lower than those before operation,with lower levels in the observation group than those in the control group(P<0.05).The incidence of delirium in the observation group was 4.65%,lower than 20.93%in the control group(P<0.05).Conclusion Combined use of dexmedetomidine and nalbuphine for general anesthesia in patients undergoing laparoscopic radical gastrectomy for gastric cancer can relieve pain degree,decrease inflammatory response,which can effectively improve the prognosis.

关 键 词：右美托咪定 纳布啡 腹腔镜胃癌根治术 全身麻醉 

分 类 号：R735.2[医药卫生—肿瘤]