结肠癌手术行右美托咪定复合麻醉对患者胃肠道功能的影响相关危险因素分析  

Analysis of Risk Factors for Effects of Dexmedetomidine Combined Anesthesia on Gastrointestinal Function in Patients Undergoing Colon Cancer Surgery

作　　者：石筱 杨保仲 SHI Xiao;YANG Baozhong(Department of Anesthesiology,Taiyuan Hospital(Taiyuan Central Hospital),Peking University First Hospital,Taiyuan 030009,China)

机构地区：[1]北京大学第一医院太原医院(太原市中心医院)麻醉科,太原030009

出　　处：《转化医学杂志》2024年第6期846-851,共6页Translational Medicine Journal

基　　金：太原市科技项目计划(202232)。

摘　　要：目的研究结肠癌患者手术行右美托咪定复合麻醉对术后胃肠道功能的影响及相关危险因素分析。方法回顾性选取2021年1年至2024年4月北京大学第一医院太原医院收治的结肠癌患者147例作为研究对象,依据病历系统记录术后是否发生胃肠功能不耐受分为发生组(52例)和未发生组(95例)。比较2组患者临床相关资料,针对差异指标采取共线性分析,将未存在共线性问题的指标纳入Logistic回归模型中分析结肠癌患者术后胃肠道功能不耐受的相关影响因素。结果2组右美托咪定剂量、麻醉时间、术中出血量、手术时间、术中平均动脉压(MAP)、术中心率(HR)比较,差异有统计学意义(t/Z=6.602、6.016、5.337、6.543、5.131、5.567,P<0.05),且上述指标均未存在共线性问题(VIF≤10,容忍度≥0.1),经Logistic回归分析发现,右美托咪定剂量、麻醉时间、术中出血量、手术时间均为其独立危险因素(OR=42.898、1.070、1.007、1.050,P<0.05),术中MAP、术中HR均与结肠癌手术患者术后胃肠功能不耐受发生具有负向影响关系,为其独立危险保护因素(OR=0.853、0.831,P<0.05)。结论麻醉剂量、麻醉时间、麻醉方式、术中出血量、手术时间、阿片类药物使用情况均为结肠癌患者术后胃肠道功能不耐受的独立影响因素,通过上述指标筛查高危群体,为临床术前采取相应干预措施提高预后提供理论参考依据。Objective To investigate the effects of dexmedetomidine combined anesthesia on postoperative gastrointestinal function in patients with colon cancer and analyze the related risk factors.Methods 147 patients with colon cancer admitted to Taiyuan Hospital of Peking University First Hospital from 1 year 2021 to April 2024 were selected as the study objects for retrospective study.Gastrointestinal intolerance was divided into occurrence group(n=52)and non-occurrence group(n=95)according to the medical record system.The relevant clinical data of patients were collected and compared,collinearity analysis was carried out for the difference indicators,and indicators without collinearity problems were incorporated into the Logistic regression model to analyze the related influencing factors of postoperative gastrointestinal functional intolerance in colon cancer patients.Results There were statistically significant differences in dexmedetomidine dose,anesthesia time,intraoperative blood loss,operative time,intraoperative MAP,and intraoperative HR(t/Z=6.602,6.016,5.337,6.543,5.131,5.567,P<0.05),and there were no collinearity problems in the above indexes(VIF≤10,Tolerance≥0.1),Logistic regression analysis showed that dexmedetomidine dose,anesthesia time,intraoperative blood loss and operation time were independent risk factors(OR=42.898,1.070,1.007,1.050,P<0.05).Both intraoperative MAP and intraoperative HR were negatively correlated with postoperative gastrointestinal intolerance in patients with colon cancer surgery,and were independent protective risk factors(OR=0.853,0.831,P<0.05).Conclusion Anesthesia dose,anesthesia time,anesthesia method,intraoperative blood loss,operation time,and opioid use were all independent influencing factors of postoperative gastrointestinal intolerance in patients with colon cancer.Screening high-risk groups by the above indicators provided theoretical reference for taking appropriate intervention measures before clinical operation to improve prognosis.

关 键 词：结肠癌 手术 胃肠道功能 右美托咪定复合麻醉 影响因素 

分 类 号：R735.3[医药卫生—肿瘤]