探讨右美托咪定辅助全身麻醉在腹腔镜结直肠癌根治术中的应用

Explore the Application of DexmedetomidineAssisted General Anesthesia in Laparoscopic Radical Colorectal Cancer

目的探讨右美托咪定辅助全身麻醉在腹腔镜结直肠癌根治术中的应用疗效。方法选取红河州滇南中心医院2018年11月至2019年11月收治的66例腹腔镜结直肠癌根治术患者,按照术中麻醉方式不同将患者分为对照组和试验组,各33例。其中对照组实行全身麻醉,试验组实行右美托咪定辅助全身麻醉,比较两组患者围麻醉期血流动力学指标、应激指标、炎症因子水平以及术后恢复情况。结果患者气管插管后5 min(T1)、气管拔除后5 min(T2)心率、平均动脉压以及血氧饱和度等血流动力学指标,试验组均优于对照组,差异有统计学意义(P<0.05)。术后24h空腹血糖、24 h皮质醇以及肾上腺素等应激指标,试验组均优于对照组,差异有统计学意义(P<0.05)。术后24 h血清白介素-6、C反应蛋白以及肿瘤坏死因子-α等炎症因子,试验组均低于对照组,差异有统计学意义(P<0.05)。术后自主呼吸恢复时间、拔管时间以及睁眼时间,试验组均比对照组早,差异有统计学意义(P<0.05)。术后不良反应发生率,试验组比对照组低,差异有统计学意义(P<0.05)。结论在腹腔镜结直肠癌根治术中,右美托咪定辅助全身麻醉干预效果优于全身麻醉效果。

Objective To investigate the effect of dexmedetomidine-assisted general anesthesia in laparoscopic radical resection of colorectal cancer.Methods A total of 66 patients undergoing laparoscopic colorectal cancer radical resection in Central Yunnan South Hospital from November 2018 to November 2019 were selected.According to the different intraoperative anesthesia methods,the patients were divided into control group:33 cases of general anesthesia,and experimental group:dexmedo In 33 cases of general anesthesia assisted by mididine,the hemodynamic indexes,stress indexes,inflammatory factor levels and postoperative recovery of the two groups were compared.Results 5 minutes after tracheal intubation(T1)and 5 minutes after tracheal removal(T2),the experimental group was better than the control group with hemodynamic indicators such as heart rate,mean arterial pressure,and blood oxygen saturation.The difference was statistically significant(P<0.05).Postoperative 24 h fasting blood glucose,24 h cortisol and adrenaline and other stress indicators,the experimental group was better than the control group,the difference was statistically significant(P<0.05).Serum interleukin-6,C-reactive protein and tumor necrosis factor-αand other inflammatory factors at 24 hours after operation were lower in the experimental group than in the control group,and the difference was statistically significant(P<0.05).Postoperative spontaneous breathing recovery time,extubation time and eye opening time,the experimental group was earlier than the control group,the difference was statistically significant(P<0.05).The incidence of postoperative adverse reactions was lower in the experimental group than in the control group,and the difference was statistically significant(P<0.05).Conclusion In laparoscopic radical resection of colorectal cancer,the effect of dexmedetomidine-assisted general anesthesia intervention is better than that of general anesthesia.