右美托咪定辅助麻醉对宫颈癌根治术患者肠道功能的影响

Effect of dexmedetomidine-assisted anesthesia on intestinal function in patients with radical operation of cervical carcinoma

目的:探讨右美托咪定对宫颈癌根治术患者肠道功能的影响。方法:选取2016年10月至2018年6月就诊于宜宾市第一人民医院择期行宫颈癌根治术患者92例为研究对象,根据随机数字表法将其分为对照组和观察组,各46例。观察组麻醉诱导前10min予以0.5μg/kg右美托咪定稀释后在10min泵完,随后以0.4μg/(kg·h)持续泵注至术毕前40min;对照组以同样方法予以等容量生理盐水。两组镇痛均使用丙泊酚和瑞芬太尼。于给药前(T1)、手术结束时(T2)、手术后2h(T3)和术后24h(T4)对炎性因子(IL-6、TNF-α)及肠道通透性指标(DAO、D-LAC)进行监测。并比较两组住院时间及肠道功能恢复情况。结果:在T2、T3、T4时,观察组血清IL-6、TNF-α水平低于对照组(P<0.05);在T2、T3、T4时,观察组血清DAO、D-LAC水平低于对照组(P<0.05);观察组术后肠鸣音恢复时间、术后首次排便时间及总住院时间均短于对照组(P<0.05)。结论:右美托咪定可减轻宫颈癌根治术患者炎性反应和肠黏膜损伤,促进肠道功能更快恢复。

Objective:To explore the effects of dexmedetomidine on intestinal function in patients with radical operation of cervical carcinoma.Methods:92 patients with radical operation of cervical carcinoma of the First People's Hospital in Yibin from October 2016 to June 2018 were selected as the subjects.According to the random digital table method,92 patients were divided into observation group and control group,and 46 cases in each group.The observation group was intravenously infused with 0.5μg/kg dexmedetomidine for 10 minutes before the induction of anesthesia,then pumped continuously with 0.4μg/(kg·h)until 40 minutes before operation.The control group was given intravenously with the equal volume of normal saline.The two groups were given with propofol and remifentanil analgesia.The inflammatory factors(IL-6,TNF-α)and indicators of intestinal permeability(DAO and D-LAC)were monitored before the administration(T1),at the end of operation(T2),2 h after operation(T3)and 24 h after operation(T4).The hospitalization time and bowel function recovery were compared between the two groups.Results:At T2,T3 and T4,serum IL-6,TNF-αlevels in observation group were lower than those in control group(P<0.05).At T2,T3 and T4,serum DAO and D-LAC levels in observation group were lower than those in control group(P<0.05).The recovery time of bowel sounds,first defecation time and total hospitalization time of the observation group were shorter than those of the control group(P<0.05).Conclusion:Dexmedetomidine can alleviate inflammatory reaction and intestinal mucosal injury in patients undergoing radical cervical cancer surgery,and promote faster recovery of intestinal function.