摘要
目的探讨右美托咪啶麻醉诱导对肝细胞癌(肝癌)切除术后麻醉恢复的影响。方法本前瞻性研究对象为2013年5月至2016年3月在中山大学附属第三医院岭南医院行肝切除术的36例肝癌患者。按随机数字表法分为右美托咪啶(DXE)组和对照组。其中DXE组18例,男13例,女5例;平均年龄(48±5)岁,麻醉诱导时给予1μg/kg DXE持续静脉泵入。对照组18例,男12例,女6例;年龄(50±3)岁,麻醉诱导时给予同体积生理盐水持续静脉泵入。患者均签署知情同意书,符合医学伦理学规定。两组自主呼吸恢复时间、苏醒时间、拔管时间等指标比较采用t检验,并发症发生率比较采用χ2检验。结果 DXE组自主呼吸恢复时间、苏醒时间、拔管时间分别为(1.7±0.4)、(4.1±1.0)、(3.8±1.9)min,明显短于对照组的(4.1±0.6)、(11.6±2.2)、(12.2±3.8)min(t=-14.12,-13.17,-8.39;P<0.05)。DXE组术后发生寒战、呛咳分别为4、5例,对照组相应为9、12例,两组寒战、呛咳发生率差异有统计学意义(χ2=4.866,5.461;P<0.05)。DXE组术后疼痛口述描绘评分(VRS)为(2.6±1.5)分,明显低于对照组的(4.1±1.7)分(t=-2.81,P<0.05)。与对照组相比,DXE组血压控制更有效,且无发生心血管不良反应事件。结论 DXE麻醉诱导可加速肝癌切除术后麻醉恢复,提高苏醒质量,降低麻醉术后并发症和心血管不良事件的发生率,且具有良好的镇痛效果。
Objective To investigate the effects of dexmedetomidine （DXE）-induced anesthesia upon recovery from anesthesia after resection of hepatocellular carcinoma （HCC）. Methods In this prospective study, 36 patients with HCC who underwent hepatectomy in Lingnan Hospital, the Third Affiliated Hospital of Sun Yat-sen University between May 2013 and March 2016 were recruited. According to random number table method, all patients were divided into the DXE group （n=18） and control group （n=18）. In the DXE group, 13 cases were males and 5 females, aged （48±5） years old on average. During the induction of anesthesia, DXE with the concentration of 1 μg/kg was continuously intravenous pumped. In the control group, 12 cases were males and 6 females, aged anesthesia, an equivalent volume of physiological saline （50±3） years old on average. During the induction of was continuously intravenous pumped. The informed consents of all patients were obtained and the local ethical committee approval was received. The spontaneous respiration recovery time, revival time and extubation time between two groups were compared using t test. The incidence of postoperative complications was compared by Chi-square test. Results The spontaneous respiration recovery time, revival time and extubation time in the DXE group was respectively （1.7±0.4）, （4.1 ±1.0） and （3.8± 1.9） rain, significantly shorter than （4.1 ±0.6）, （11.6±2.2） and （12.2±3.8） rain in the control group （t=-14.12, -13.17, -8.39; P〈0.05）. Four cases of chill and 5 cases of choking cough were observed in the DXE group, while 9 and 12 in the control group, and significant differences were observed in the incidence of chill and choking cough between two groups （x^2=4.866, 5.461; P〈0.05）. The postoperative pain verbal rating scale （VRS） in the DXE group was 2.6±1.5, significantly lower than 4.1±1.7 in the control group （t=-2.81, P〈0.05）. Compared with the control group, the blood pressure was more effectively controlled in the DXE group. No cardiovascular adverse event was observed in the DXE group. Conelusions DXE- induced anesthesia can accelerate the recovery from anesthesia after resection of HCC, enhance the quality of revival, reduce the incidence of postoperative anesthesia related complications and cardiovascular adverse events, and has favorable analgesic effects.
出处
《中华肝脏外科手术学电子杂志》
CAS
2017年第5期405-409,共5页
Chinese Journal of Hepatic Surgery(Electronic Edition)
基金
广东省科技计划项目(2010B060900024)
关键词
右美托咪啶
肝切除术
癌
肝细胞
麻醉诱导
麻醉恢复期
Dexmedetomidine
Hepatectomy
Carcinoma, hepatocellular
Induction of anesthesia
Anesthesia recovery period
