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中国初级卫生保健:2023,37(9):86-93
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右美托咪定对老年结直肠肿瘤患者腹腔镜手术后 脑功能的影响*
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中文摘要: 摘 要:目的:对右美托咪定 (DEX) 用于老年患者结直肠肿瘤腹腔镜手术的效果进行分析,以期为DEX的临床应用及 相关疾病的治疗提供参考依据。方法:2021年6月—2022年9月以上海金山亭林医院收治的60例行腹腔镜手术的结直肠肿瘤 患者为研究对象,采用随机数字表法将其分成实验组 (n=30) 和对照组 (n=30)。实验组在麻醉诱导前静脉泵入DEX,对照 组给予同等计量的生理盐水维持麻醉。比较两组患者平均动脉压、心率等观察指标情况。结果:术后,实验组患者神经元特 异性烯醇化酶、血清肿瘤坏死因子-α、超氧化物歧化酶、白细胞介素-6水平低于对照组,差异有统计科学意义 (F值分别为 16.023、40.017、10.774和43.751,P值均<0.05),P值均<0.05);实验组Ramsay镇静、Riker镇静和躁动、痛视觉模拟评分 分别为 (2.15±0.41) 分、(4.11±0.69) 分和 (3.10±0.87) 分,均低于对照组,差异有统计科学意义 (t值分别为8.431、3.209 和3.732,P值均<0.05);实验组舒适度评分为 (2.88±0.51) 分,高于对照组的 (2.10±0.39) 分,差异有统计科学意义 (t= 6.654,P<0.05);对照组认知功能障碍发生率为 33.33%,高于实验组 (10.00%),差异有统计科学意义 (χ 2 =4.812,P< 0.05)。结论:老年结直肠癌根治术中持续应用DEX静脉泵入有利于控制患者机体炎症反应,稳定血流动力学水平,改善苏醒 期评分,降低POCD发生率。
Abstract:Abstract: OBJECTIVE The effect of dexmedetomidine (DEX) in laparoscopic surgery for colorectal tumors in elderly patients was analyzed in order to provide a reference for the clinical application of DEX and the treatment of related diseases. METHODS From June 2021 to September 2022, 60 patients with colorectal cancer undergoing laparoscopic surgery in Shanghai Jinshan Tinglin hospital were selected and divided into DEX group (n=30) and control group (n=30) by random number table method. DEX group was intravenously pumped with DEX before induction of anesthesia. The control group was given the same amount of normal saline to maintain anesthesia. The mean arterial pressure, heart rate and other relative indicators were compared between the two groups. RESULTS Postoperative, In the DEX group, the NSE, TNF- α, SOD, and IL-6 levels in the patients were lower than those in the control group, the differences showed statistical scientific significance (t=4.902, 7.174, 3.266, 5.457, P<0.05); In the DEX group, Ramsay sedation, Riker sedation and agitation, and VAS scores were (2.15 ± 0.41), (4.11 ± 0.69) and (3.10 ± 0.87), respectively, and were lower than those in the control group, the difference showed statistical scientific significance (t=8.431,3.209, 3.732, P< 0.05). Comfort score of DEX group was (2.88 ± 0.51), and was Higher (2.10 ± 0.39) score than the control group of statistical scientif⁃ ic significance (t=6.654, P<0.05). The incidence of POCD was 33.33%, and was igher than that in the DEX group (10.00%), with statistical scientific significance (χ2 =4.812, P<0.05). The mean arterial pressure, heart rate, and BIS values in the DEX group at awakening, immediately and at extubation for 5 min were lower than those in the control group. CONCLUSION Continuous applica⁃ tion of DEX intravenous pump during radical resection of colorectal cancer in elderly patients is beneficial to control the inflammato⁃ ry reaction, stabilize the hemodynamic level, improve the recovery period score, and reduce the incidence of POCD.
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