七氟烷复合右美托咪定麻醉对腹腔镜结肠癌术后应激反应的影响  

Effect of sevoflurane combined with dexmedetomidine anesthesia on stress response after laparoscopic colon cancer surgery

作　　者：杨自娟 王冰[1] 丘宇[1] YANG Zijuan;WANG Bing;QIU Yu(Department of Anesthesiology,Yuebei People's Hospital,Shaoguan,Guangdong,510026,China)

机构地区：[1]粤北人民医院麻醉科,广东韶关510026

出　　处：《当代医学》2024年第25期5-10,共6页Contemporary Medicine

摘　　要：目的探究七氟烷复合右美托咪定麻醉对腹腔镜结肠癌术后应激反应的影响。方法选取2020年11月至2022年11月于粤北人民医院行腹腔镜结肠癌术的80例患者作为研究对象,按照随机数表法分为研究组与对照组,各40例。对照组采用七氟烷麻醉,研究组采用七氟烷复合右美托咪定麻醉。比较两组血流动力学指标(心率、平均动脉压)、镇痛镇静效果[视觉模拟评分法(visual analogue scale,VAS)、Ramsay镇静量表(Ramsay sedation scale,RSS)评分]、免疫功能指标(IgG、IgA、IgM、CD4+T细胞、CD8+T细胞)、应激反应指标[醛固酮(aldosterone,ALD)、促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)、皮质醇(cortisol,Cor)、去甲肾上腺素(norepinephrine,NA)]、认知功能指标[S100钙结合蛋白β(S100 calcium binding proteinβ,S-100β)、神经元特异性烯醇化酶(neuron-specific enolase,NSE)水平及简明精神状态检查量表(mini-mental state examination,MMSE)评分]、躁动情况[苏醒期躁动评分(restlessness score,RS)]、术后恢复质量[恢复质量问卷表(quality of recovery-40,QoRⅠ40)]及不良反应发生率。结果术中、术后,研究组心率均慢于对照组,平均动脉压均低于对照组,差异有统计学意义(P<0.05)。术中及术后4、12、24 h,研究组VAS评分、Ramsay评分均低于对照组,差异有统计学意义(P<0.05)。术后24 h,研究组IgG、IgA、IgM、CD4+T细胞水平均高于对照组,CD8+T细胞水平低于对照组,差异有统计学意义(P<0.05)。术后24 h,研究组ALD、IACTH、Cor、NA水平均低于对照组,差异有统计学意义(P<0.05)。术后24 h,研究组S-100β、NSE水平均低于对照组,MMSE评分高于对照组,差异有统计学意义(P<0.05)。研究组RS评分低于对照组,QoRⅠ40评分高于对照组,差异有统计学意义(P<0.05);研究组不良反应发生率为10.00%,低于对照组的27.50%,差异有统计学意义(P<0.05)。结论七氟烷复合右美托咪定麻醉应用于腹腔镜结肠癌Objective To explore the effect of sevoflurane combined with dexmedetomidine anesthesia on stress response after laparoscopic co-lon cancer surgery.Methods 80 patients who underwent laparoscopic colon cancer surgery in Yuebei People's Hospital from November 2020 to No-vember 2022 were selected as the research subjects,and they were divided into the study group and the control group according to random number table method,with 40 cases in each group.The control group was anesthetized with sevoflurane,while the study group was anesthetized with sevoflu-rane combined with dexmedetomidine.The hemodynamic indexes(heart rate,mean arterial pressure),analgesic and sedative effect(visual analogue scale[VAS]and Ramsay sedation scale[RSS]scores),immune function indicators(IgG,IgA,IgM,CD4+T cells,CD8+T cells),stress response indica-tors(aldosterone[ALD],adrenocorticotropic hormone[ACTH],cortisol[Cor],norepinephrine[NA]),cognitive function indicators(S100 calcium binding proteinβ[S-100β],neuron-specific enolase[NSE]levels and mini-mental state examination[MMSE]score),and agitation status(restless-ness score[RS]),postoperative recovery quality(quality of recovery-40[QoRⅠ40]score)and incidence of adverse reactions were compared be-tween the two groups.Results During and after the operation,the heart rate in the study group were slower than that in the control group,and the mean arterial pressure were lower than that in the control group,and the differences were statistically significant(P<0.05).During operation and 4,12,24 h after operation,the VAS scores and the Ramsay scores in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).At 24 h after operation,the levels of IgG,IgA,IgM and CD4+T cells in the study group were higher than those in the control group,and the level of CD8+T cells was lower than that in the control group,and the differences were statistically significant(P<0.05).At 24 h after operation,the levels of ALD,IACTH,Cor and NA in the study group we

关 键 词：七氟烷 右美托咪定 应激反应 结肠癌 

分 类 号：R73[医药卫生—肿瘤]