摘要
目的探讨术中使用右美托咪定对腹腔镜结肠癌根治术患者术后快速康复效果的影响。方法选择腹腔镜结肠癌根治术患者80例,电脑随机分组分为右美托咪定(D)组,对照(C)组,每组40例。手术采用全麻气管插管,麻醉诱导后C组采用静吸复合麻醉,使用丙泊酚,瑞芬太尼,罗库溴铵联合七氟醚维持麻醉,D组在C组基础上泵入右美托咪定,使用麻醉深度监护仪(Narcortrend)监测麻醉深度,维持麻醉深度指数(narcortrend index,NI)值为D1(56~47)。患者都采用切口局部麻醉镇痛,不使用阿片类术后镇痛药。于麻醉前(T1)、术后6h(T2)、24h(T3)、72h(T4)对患者进行VAS疼痛评分,取静脉血浆检测患者CRP含量。记录患者肛门首次排气时间,首次下床活动时间,术后住院时间。结果与C组比较,D组T2、T3、T4时间点血浆CRP含量明显较低(P<0.05),VAS疼痛评分明显较低(P<0.05);与C组比较,D组术后肛门首次排气时间明显缩短(P<0.05),首次下床活动时间明显较早(P<0.05);两组术后住院时间差异无统计学意义(P>0.05)。结论在结肠癌根治术术中使用右美托咪定有助于减轻患者应激反应,减轻患者术后疼痛,加快患者快速康复。
Objective To explore the effect of dexmedetomidine on the rapid rehabilitation after laparoscopic radical resection of colon cancer.Methods 80 patients with laparoscopic radical resection of colon cancer were randomly divided into dexmedetomidine（ D） group and control group（ C）,each group had 40 cases. General anesthesia for tracheal intubation was used for surgery.After induction of anesthesia,C group was used static inhalation combined anesthesia,propofol,remifentanil,rocuronium bromide and sevoflurane were used to maintain anesthesia,and group D was pumped medetomidine on the basis of group C,using Narcortrend to monitor the depth of anesthesia and maintain the narcortrendindex（ NI） D1（ 56 to 47）.The patients were treated with local incision anaesthesia for analgesia,and no opioid analgesics were used.Before anesthesia（ T1）,postoperative 6 h（ T2）,24 h（ T3）,and72 h（ T4）,the pain scores of the patients were evaluated,and the venous plasma was used to detect the CRP content of the patients.The time of first postoperative anus exhausting,the time of first going out of bed,and the time of postoperative hospitalization were recorded.Results Compared with C group,CRP content of plasma at T2,T3,T4 time point of D group was significantly lower（ P〈0. 05）,VAS pain score was significantly lower（ P〈0. 05）; compared with C group,the time of first postoperative anus exhausting of D group was significantly shortened（ P〈0. 05）,the time of first going out of bed was earlier（ P〈0. 05）; postoperative hospitalization time was no statistically significant difference（ P〉0. 05）. Conclusion The use of dexmedetomidin in the radical resection of colon cancer helps to reduce the stress response,relieve postoperative pain and accelerate the patients＇ rapid recovery.
作者
魏湘华
段红
李文瑶
张可贤
Wei Xianghua;Duan Hong;Li Wenyao(Medical School of the University of Electronic Science and Technology.Chengdu,Sichuan 610041,China.)
出处
《四川医学》
CAS
2018年第5期538-541,共4页
Sichuan Medical Journal
关键词
右美托咪定
应激
手术
结肠癌
快速康复
dexmedetomidine；stress response；operation
colon cancer；rapid recovery
