右美托咪定联合七氟烷吸入麻醉对肝癌患者根治术后心功能及胃肠道功能的影响  

Effects of Dexmedetomidine Combined with Sevoflurane Inhalation Anesthesia on Cardiac Function and Gastrointestinal Function in Patients with Hepatocellular Carcinoma After Radical Resection

作　　者：张春丽[1] 徐志新 孙虎[1] 王文婷 Zhang Chunli;Xu Zhixin;Sun Hu;Wang Wenting(Department of Anesthesiology,The Second Affiliated Hospital of Hainan Medical University,Haikou 570311,China)

机构地区：[1]海南医学院第二附属医院麻醉科,海口570311

出　　处：《成都医学院学报》2024年第4期649-653,共5页Journal of Chengdu Medical College

基　　金：海南省卫生健康委员会卫生健康行业科研项目(No:21A200208)。

摘　　要：目的探究右美托咪定联合七氟烷吸入麻醉对肝癌患者根治术后心功能及胃肠道功能的影响。方法选取2021年1月至2022年7月海南医学院第二附属医院肿瘤科收治的行根治术和淋巴结清扫术治疗的肝癌患者共64例为研究对象,根据随机数字表法随机分为试验组(n=32)和对照组(n=32),对照组患者行丙泊酚麻醉,试验组患者采用右美托咪定联合七氟烷吸入麻醉。记录患者肠道恢复时间、血清肠型脂肪酸结合蛋白(I-FABP)水平等指标及患者不良反应发生情况。结果试验组患者肠鸣音恢复、首次肛门排气、首次自主排便、住院时间均早于对照组(P<0.05),术后2 h I-FABP水平均低于对照组(P<0.05);肠内营养开始时间晚于对照组(P<0.05);T1及T2时,两组患者心率(HR)、每搏输出量(SV)、心输出量(CO)、心脏指数(CI)、左心室舒张末期内径(LVEDD)均较T0降低,且试验组高于对照组(P<0.05),两组左心室射血分数(LVEF)均较T0升高,试验组低于对照组(P<0.05);T3时,两组肌酸磷化酶-同功酶MB(CK-MB)、心肌肌钙蛋白Ⅰ(cTnⅠ)、凝血活酶时间(aPTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原浓度(Fbg)、血浆血栓素B2(TXB2)、血小板α颗粒膜蛋白(GMP)及血小板最大聚集率(PAGmax)水平均较T0时升高,且试验组患者除PAGmax水平高于对照组外,其余指标均低于对照组(P<0.05);试验组患者不良反应发生率低于对照组(P<0.05)。结论肝癌患者在行根除术治疗中,使用右美托咪定联合七氟烷吸入麻醉能够促进术后肠道功能康复,对心功能保护效果较好。Objective To explore the effects of dexmedetomidine combined with sevoflurane inhalation anesthesia on the cardiac function and gastrointestinal function in patients undergoing radical resection of hepatocellular carcinoma(HCC).Methods A total of 64 patients with HCC who received radical resection and lymph node dissection in the Department of Oncology,the Second Affiliated Hospital of Hainan Medical University from January 2021 to July 2022 were selected as the research objects.They were randomly divided into experimental group(n=32)and control group(n=32)by means of the random number table method.The patients in the control group were anesthetized with propofol,while the patients in the experimental group were anesthetized with dexmedetomidine combined with sevoflurane inhalation.The recovery time of intestinal function,serum intestinal fatty acid binding protein(I-FABP)level and other cardiac function and gastrointestinal function indicators and incidence of adverse reactions were recorded.Results Compared with the control group,the experimental group had earlier first bowel sounds,first passage of flatus and first defecation,shorter length of stay,lower level of serum I-FABP at 2 h after surgery,and delayed enteral nutrition support(P<0.05).At T1(10 min after anesthesia induction)and T2(30 min after anesthesia induction),the heart rate(HR),stroke volume(SV),cardiac output(CO),cardiac index(CI)and left ventricular end-diastolic diameter(LVEDD)in both groups were lower than those at T0(before anesthesia induction),and the indicators at T1 and T2 were higher in the experimental group than those in the control group(P<0.05).The left ventricular ejection fraction(LVEF)in both groups at T1 and T2 was higher than that at T0,and that in the experimental group was lower than that in the control group(P<0.05).At T3,the levels of creatine kinase isoenzyme-MB(CK-MB),cardiac troponini I(cTnI),activated partial thromboplastin time(aPTT),prothrombin time(PT),thrombin time(TT),fibrinogen(Fbg),plasma thromboxane B2(TXB2),plat

关 键 词：原发性肝癌 右美托咪定 七氟烷 心功能 胃肠道功能 

分 类 号：R614.2[医药卫生—麻醉学]