摘要
目的观察围术期应用右美托咪啶对结肠癌根治术后肠麻痹的影响。方法选取2015年6月至2016年6月收治结肠癌患者126例为研究对象,随机分为观察组和对照组,观察组患者在全麻诱导前注射右美托咪啶,对照组注射等量生理盐水。观察两组手术时间、失血量、输液量、术后丙泊酚、瑞芬太尼用量和胃肠功能情况。分别在输注右美托咪啶或生理盐水前(T1)、气管插管后5 min(T2)、气腹开始(T3)、气腹1 h(T4)、气腹解释10 min(T5)、拔管即刻(T6)测定去甲肾上腺素(NE)和肾上腺素(E)、HR、MAP、LF、HF和LF/HF。结果观察组术后丙泊酚、瑞芬太尼用量显著少于对照组(P<0.05)。观察组患者术后排气时间、肠鸣音恢复时间显著短于对照组(P<0.05)。在T2~T6时刻,两组患者LF、LF/HF差异显著(P<0.05)。两组患者T3、T5时刻E和NE均升高,并且对照组患者上升更加明显。结论结肠癌根治术患者围术期使用右美托咪啶能够缩短肠麻痹时间,促进术后胃肠功能的恢复。
Objective To observe the effect of perioperative application of dexmedetomidine on intestinal paralysis after radical operation of colon cancer, and to provide the reference for clinical application.Methods A total of 126 patients with colon cancer in this hospital during June 2015 to June 2016 were selected for this study, they were randomly divided into observation group and control group according to randomized method.Patients in observation group were applied with dexmedetomidine before induction of general anesthesia.The operating time, amount of blood loss and volume of infusion, the dosage of postoperative application of propofol and remifentanil and gastrointestinal function were observed in patients of these 2 groups.The application of norepinephrine （NE） and epinephrine （E）, HR, MAP, LF, HF and LF/H were determined during the infusion of dexmedetomidine or normal saline （T1）, 5 min after intubation （T2）, pneumoperitoneum （T3）, starting at 1 h （T4）, pneumoperitoneum accounted for 10 min （T5） and extubation （T6）.Results The dosage for postoperative application of propofol and fentanyl in patients of observation group was significantly less than that in patients of control group （P〈0.05）.The postoperative exhaust time and duration for recovery of bowel sound in patients of observation group were significantly shorter than those of patients in control group （P〈0.05）.LF in T2~T6 moments, in patients of these two groups, and the difference in LF/HF was significant （P〈0.05）.E and N in patients of these 2 groups at T3 and T5 moments were higher, more obvious increase in the number and controlled way.Conclusion Perioperative application of dexmedetomidine in patients with radical resection of colon cancer can shorten the duration for paralysis of intestine and promote the recovery of gastrointestinal function after operation.
出处
《临床和实验医学杂志》
2017年第14期1451-1454,共4页
Journal of Clinical and Experimental Medicine
关键词
结肠癌根治术
肠麻痹
右美托咪啶
甲肾上腺素
Colon cancer radical operation
Intestinal paralysis
Dexmedetomidine
Norepinephrine
