不同剂量右美托咪定对老年腹腔镜胃癌根治术患者术后认知功能及炎症因子水平的影响  

The Effect of Different Doses of Dexmedetomidine on Postoperative Cognitive Function and Inflammatory Cytokine Levels in Elderly Patients Undergoing Laparoscopic Gastric Cancer Resection

作　　者：付宏博 杨莉 FU Hongbo;YANG Li(Department of Anesthesiology,Affiliated Hospital of Xizang Minzu University,Xianyang Shaanxi 712082)

机构地区：[1]西藏民族大学附属医院麻醉科,陕西咸阳712082 [2]宝鸡高新医院麻醉手术科,陕西宝鸡721000

出　　处：《医学临床研究》2024年第12期1899-1902,共4页Journal of Clinical Research

摘　　要：【目的】探讨不同剂量右美托咪定(Dex)对老年腹腔镜胃癌根治术(LAGRP)患者术后认知功能及炎症因子水平的影响。【方法】128例拟行LAGRP的老年患者,随机分为对照组(C组)和不同剂量Dex组(D1组,D2组,D3组),每组32例。患者均采用全身麻醉,麻醉维持期间D1组、D2组与D3组分别给予0.2μg/(kg·h)、0.5μg/(kg·h)、0.6μg/(kg·h)的Dex静脉泵注辅助麻醉,C组给予等容量生理盐水。比较四组患者围手术期指标、疼痛情况、认知功能、炎症细胞因子水平和不良反应发生情况。【结果】四组手术时间、术中出血量、住院时间比较,差异均无统计学意义(P>0.05);D3组苏醒时间长于C组、D1组和D2组(P<0.05)。D1组、D2组、D3组术后48 h视觉模拟评分法(VAS)评分低于C组(P<0.05)。D1组、D2组、D3组术后1 d、术后3 d简易智力状态量表(MMSE)评分高于C组(P<0.05)。D1组、D2组、D3组术后1 d、术后3 d血清C反应蛋白(CRP)、降钙素原(PCT)水平低于C组(P<0.05)。四组术后不良反应总发生率比较,差异均无统计学意义(P>0.05)。【结论】不同剂量Dex麻醉均可改善老年LAGRP患者认知功能,抑制炎症反应,且安全性良好,而Dex剂量为0.5μg/(kg·h)的麻醉整体效果相对较好。【Objective】To explore the effects of different doses of dexmedetomidine(Dex)on postoperative cognitive function and inflammatory cytokine levels in elderly patients undergoing laparoscopic gastric cancer resection(LAGRP).【Methods】A total of 128 elderly patients scheduled for LAGRP were randomly divided into a control group(C group)and three different doses of Dex groups(D1 group,D2 group,D3 group),with 32 patients in each group.All patients received general anesthesia.During anesthesia maintenance,the D1 group,D2 group,and D3 group were given dexmedetomidine via intravenous infusion at doses of 0.2μg/(kg·h),0.5μg/(kg·h),and 0.6μg/(kg·h),respectively,while the C group received an equal volume of saline.The perioperative indicators,pain severity,cognitive function,inflammatory cytokine levels,and incidence of adverse reactions were compared among the four groups.【Results】There were no significant differences in surgery duration,intraoperative blood loss,or length of hospital stay among the four groups(P>0.05).The D3 group had a longer awakening time compared to the C group,D1 group,and D2 group(P<0.05).Postoperative 48-hour Visual Analog Scale(VAS)pain scores were lower in the D1 group,D2 group,and D3 group compared to the C group(P<0.05).The Mini-Mental State Examination(MMSE)scores on postoperative days 1 and 3 were higher in the D1 group,D2 group,and D3 group compared to the C group(P<0.05).C-reactive protein(CRP)and procalcitonin(PCT)levels on postoperative days 1 and 3 were lower in the D1 group,D2 group,and D3 group compared to the C group(P<0.05).There were no significant differences in the total incidence of adverse reactions among the four groups(P>0.05).【Conclusion】Dexmedetomidine at different doses can improve postoperative cognitive function and inhibit inflammatory responses in elderly patients undergoing LAGRP,with good safety.A dose of 0.5μg/(kg·h)showed the best overall effect.

关 键 词：胃肿瘤 右美托咪定 腹腔镜检查 胃切除术 认知 炎症趋化因子类 老年人 

分 类 号：R735.2[医药卫生—肿瘤]