右美托咪定对甲状腺肿瘤切除术全身麻醉恢复期间的影响  

Effect of Dexmedetomidine on Perioperative Stress Response and Cough Reflex during Thyroid Tumor Resection under General Anesthesia

作　　者：杨志远 张青 张军[1] 刘远征 YANG Zhiyuan;ZHANG Qing;ZHANG Jun;LIU Yuanzheng(Department of Anesthesiology,Second Surgery,Nanyang Central Hospital,Nanyang Henan 473009,China)

机构地区：[1]南阳市中心医院手术二部麻醉科,河南南阳473009

出　　处：《临床研究》2024年第5期59-62,共4页Clinical Research

摘　　要：目的 探讨患者甲状腺肿瘤切除术全身麻醉恢复期间采用右美托咪定(Dex)对应激指标及呛咳反应的影响。方法 选取2022年2月至2023年8月于南阳市中心医院行甲状腺肿瘤切除术全身麻醉的60例患者,以随机数字表法分成研究组(n=30)和对照组(n=30),对照组术中给予生理盐水持续泵注,研究组术中给予Dex持续泵注,比较两组应激指标、疼痛程度、呛咳反应及躁动情况。结果 两组术后24 h去甲肾上腺素(NE)、一氧化氮(NO)、皮质醇(Cor)、丙二醛(MDA)水平升高,差异有统计学意义(P <0.05),但研究组低于对照组,差异有统计学意义(P <0.05);两组术后6 h、12 h、24 h视觉模拟评分法(VAS)评分较术后3 h下降,且研究组低于对照组,差异有统计学意义(P <0.05);研究组呛咳反应发生率[6.67%(2/30)]低于对照组[30.00%(9/30)],差异有统计学意义(P <0.05);研究组躁动发生率[3.33%(1/30)]低于对照组[26.67%(8/30)],差异有统计学意义(P <0.05)。结论 Dex应用于甲状腺肿瘤切除术全身麻醉中,能够有效减轻恢复期间对应激指标的影响,降低疼痛程度,降低呛咳反应及躁动情况发生率。Objective To investigate the effects of dexmedetomidine(Dex) on perioperative stress response and cough reflex in patients undergoing thyroid tumor resection under general anesthesia.Methods Sixty patients undergoing thyroid tumor resection under general anesthesia in Nanyang Central Hospita from February 2022 to August 2023 were selected and randomly divided into a study group(n=30) and a control group(n=30) using a random number table.The control group received continuous infusion of normal saline during the operation,while the study group received continuous infusion of Dex during the operation.The stress indicators,pain intensity,cough reflex,and agitation were compared between the two groups.Results The levels of norepinephrine(NE),nitric oxide(NO),cortisol(Cor),and malondialdehyde(MDA) in both groups increased 24hours after surgery,with statistically significant differences(P < 0.05),but the levels in the study group were lower than those in the control group,with statistically significant differences(P < 0.05);the visual analog scale(VAS) scores at 6 hours,12hours,and 24 hours after surgery were lower than those at 3 hours after surgery,and the scores in the study group were lower than those in the control group,with statistically significant differences(P < 0.05);the incidence of cough reflex in the study group [6.67%(2/30)] was lower than that in the control group [30.00%(9/30)],with statistically significant differences(P <0.05);the incidence of agitation in the study group [3.33%(1/30)] was lower than that in the control group [26.67%(8/30)],with statistically significant differences(P < 0.05).Conclusion Dexmedetomidine used in general anesthesia for thyroid tumor resection can effectively reduce the perioperative stress response,alleviate pain,and decrease the incidence of cough reflex and agitation during the recovery period.

关 键 词：右美托咪定 甲状腺肿瘤切除术 全身麻醉 应激指标 呛咳反应 

分 类 号：R736.1[医药卫生—肿瘤]