右美托咪定对老年腹腔镜胆囊切除患者围术期应激反应及肾功能的影响

Effect of dexmedetomidine on perioperative stress response and renal function in elderly patients undergoing laparoscopic cholecystectomy

目的探讨右美托咪定对老年腹腔镜胆囊切除患者围术期应激反应及肾功能的影响。方法将2015年6月～2017年10月于本院行腹腔镜胆囊切除术治疗的80例老年患者纳入研究并随机分组。观察组在麻醉诱导前予0.5μg/kg剂量的右美托咪定,对照组40例则采用等容量的0.9%氯化钠注射液,均输注10 min,比较两组麻醉前及术后第7天时肾功能情况,比较两组麻醉前、拔管即刻、拔管后5 min的心率(HR)、血氧饱和度(SpO2)情况。结果治疗第7天时观察组血肌酐(Scr)、尿素氮(BUN)低于对照组,差异具有统计学意义(P<0.05);观察组拔管即刻时的HR低于对照组(P<0.05);两组患者麻醉前、拔管后5 min的HR、SpO2比较,差异均无统计学意义。结论对于老年腹腔镜胆囊切除患者围术期患者而言麻醉诱导前予右美托咪定可降低应激反应,减轻肾功能损伤,值得推广。

Objective To investigate the effect of dexmedetomidine on stress response and renal function in elderly patients undergoing laparoscopic cholecystectomy. Methods 80 elderly patients who underwent laparoscopic cholecystectomy in our hospital from June 2015 to October 2017 were randomly divided into two groups. The observation group was given dexmedetomidine 0.5 ug/kg before anesthesia induction, and the control group was given 0.9% sodium chloride injection of equal volume for 10 minutes. The renal function of the two groups was compared before anesthesia and 7 days after operation. The heart rate （HR） and blood oxygen saturation （SpO2） were compared between the two groups before anesthesia, immediately after extubation and 5 minutes after extubation. Situation. Results The levels of serum creatinine （Scr） and urea nitrogen （BUN） in the observation group were significantly lower than those in the control group on the 7th day after treatment （P〈0.05）; the HR of the observation group was lower than that of the control group immediately after extubation （P〈0.05）; there was no significant difference in HR and SpO2 between the two groups before anesthesia and 5 minutes after extubation. Conclusion For elderly patients undergoing laparoscopic cholecystectomy, dexmedetomidine before anesthesia induction can reduce stress response and reduce renal function damage, which is worth promoting.