右美托咪啶复合依托咪酯对胃癌根治术患者的影响

Effects of Dexmedetomidine Combined with Etomidate on Patients Undergoing Radical Gastrectomy

目的探讨右美托咪啶复合依托咪酯对胃癌根治术患者苏醒质量、血流动力学及认知功能障碍的影响.方法选择择期行胃癌根治术的80例患者,根据随机数字表法将其分为对照组和观察组,对照组给予依托咪酯辅助诱导麻醉,观察组给予右美托咪啶复合依托咪酯麻醉.观察的血流动力学指标包括心率(HR)、收缩压(SBP)、舒张压(DBP);记录两组患者可唤醒时间、拔管呛咳以及躁动发生情况;术前1 d与术后3 d进行简易精神状态量表(MMSE)评分,观察术后认知功能障碍(POCD)发生情况.结果观察组T 0时间点HR、SBP、DBP与对照组比较差异均无统计学意义(P>0.05);T 1、T 2、T 3时间点HR、SBP、DBP均低于对照组(P<0.05).观察组可唤醒时间与对照组比较差异均无统计学意义(P>0.05),拔管呛咳发生率和躁动发生率均低于对照组(P<0.05).观察组术后3 d MMSE评分高于对照组(P<0.05),术后POCD发生率高于对照组(P<0.05).结论右美托咪啶复合依托咪酯可维持胃癌根治术患者术中血流动力学稳定,提高其苏醒质量,减轻患者的术后认知障碍.

Objective To investigate the effects of dexmedetomidine combined with etomidate on the recovery quality,hemodynamics and cognitive dysfunction of patients undergoing radical gastrectomy.Method 80 patients who underwent elective radical gastrectomy were enrolled.They were divided into the control group and the observation group according to the random number table method.The control group was given etomidate-assisted induction anesthesia.The observation group was given dexmedetomidine combined with etomidate anesthesia.The hemodynamic indexes in both groups were observed,including heart rate(HR),systolic blood pressure(SBP)and diastolic blood pressure(DBP).The wake-up time,extubation bucking and agitation of two groups were recorded.The scoring of mini-mental state examination(MMSE)was performed at 1 day before surgery and 3 days after surgery.The postoperative cognitive dysfunction(POCD)were observed.Results There was no significant difference in HR,SBP or DBP between the two groups at T 0(P>0.05).The HR,SBP and DBP at T 1,T 2 and T 3 were lower than those in the control group(P<0.05).There was no significant difference in the wake-up time between the two groups(P>0.05).The incidence of extubation bucking and agitation were lower than in the control group(P<0.05).The MMSE score of the observation group was higher than that of the control group at 3 days after surgery(P<0.05),the incidence of POCD was higher than that of the control group(P>0.05).Conclusion Dexmedetomidine combined with etomidate can maintain the hemodynamic stability of patients undergoing radical gastrectomy,improve the recovery quality and reduce postoperative cognitive dysfunction.