右美托咪定麻醉对开腹手术患者手术情况、RAAS活性及肾功能的影响

Effects of dexmedetomidine anesthesia on surgery condition,RAAS activity and renal function in laparotomy

目的研究右美托咪定麻醉对开腹手术患者手术情况、肾素-血管紧张素-醛固酮系统（renin-angiotensin-aldosterone system,RAAS）活性及肾功能的影响。方法选择2012年5月～2015年10月期间在台州市肿瘤医院接受开腹手术的96例患者进行研究,采用随机数表法分为右美托咪定组（D组）和对照组（C组）并接受不同的麻醉方案,比较2组患者的手术情况、肾功能指标以及血浆肾素及血管紧张素Ⅱ含量。结果 D组和C组患者的手术时间、术中出血量、术中输液量以及苏醒时间均无显著性差异;开腹后10 min和关腹前10 min,D组患者的血浆肾素、血管紧张素II、胱抑素C（cystatin C,Cys-C）、α1-微球蛋白（α1-microglobulin,α1-MG）含量显著低于C组（P〈0.05）。结论右美托咪定麻醉用于开腹手术能够抑制RAAS系统的激活、保护肾功能,麻醉效果更为确切。

Objective To study the effect of dexmedetomidine anesthesia on surgery condition,renin-angiotensin-aldosterone system（ RAAS）activity and renal function of laparotomy patients. Methods 96 patients received laparotomy in our hospital during May 2012 to October 2015 were studied,which were divided into dexmedetomidine group（ D group） and control group（ C Group） by random number table method and received different anesthetic regimes. Then surgery condition,renal function indexes and plasma renin,angiotensin II levels of two groups were compared. Results The operation time,intraoperative blood loss,intraoperative transfusion volume and awakening time of D group and C group had no significant difference. 10 min after opening abdomen and 10 min before closing abdomen,the plasma renin,angiotensin II,cystatin C（ Cys-C）,α1-microglobulin（ α1-MG）contents were significantly lower than those of C group（ P〈0. 05）. Conclusion Dexmedetomidine anesthesia applicated in laparotomy could inhibit the RAAS activity,protect renal function,and its anesthesia effect is more precise.