右美托咪定对腹腔镜结肠癌根治术患者肠道黏膜屏障功能的影响

EFFECT OF DEXMEDETOMIDINE ON INTESTINAL MUCOSAL BARRIER FUNCTION IN PATIENTS UNDERGOING LAPAROSCOPIC RADICAL RESECTION OF COLON CANCER

目的观察右美托咪定对腹腔镜结肠癌根治术患者免疫功能、肠道黏膜屏障功能的影响。方法选择80例腹腔镜结肠癌根治术患者,按照随机数字表法分为观察组与对照组各40例,二组均采取相同麻醉方案,观察组于诱导前泵注右美托咪定0.5~1.0μg/kg,时间10 min,随后泵注0.5μg/(kg·h);对照组给予等剂量生理盐水。比较二组术后肠道功能恢复情况、血浆D-乳酸及内毒素(LPS)水平、免疫功能指标,并统计二组术中不良反应情况。结果与对照组比较,观察组肠鸣音恢复时间、第一次排气时间、第一次排便时间均降低(均P<0.05);术后1d二组血浆D-乳酸及内毒素水平均升高,但观察组低于对照组(均P<0.05);术后1d二组CD3^+、CD4^+水平均降低,CD8^+水平均升高,但观察组CD3^+、CD4^+水平均高于对照组,CD8^+水平低于对照组(均P<0.05);观察组不良反应发生率低于对照组(P<0.05)。结论右美托咪定对腹腔镜结肠癌根治术患者免疫、肠道黏膜屏障功能具有保护作用。

Objective To observe the effect of dexmedetomidine on immune function and intestinal mucosal barrier function in patients undergoing laparoscopic radical resection of colon cancer.Methods Eighty cases of patients with laparoscopic radical resection of colon cancer were randomly divided into observation group and control group,40 cases in each group.Both groups were given the same anesthesia regimen.The observation group was injected with dexmedetomidine 0.5~1.0μg/kg in 10 min before induction,followed pump injection 0.5μg/(kg·h).The control group was given equal doses of normal saline.The postoperative intestinal function recovery,plasma d-lactic acid and endotoxin(LPS)levels,and immune function indexes of the two groups were compared,and the intraoperative adverse reactions of the two groups were statistically analyzed.Results Compared with control group,the recovery time of bowel sounds,the first exhaust time and thefirst defecation time in the observation group were all reduced(P<0.05).Plasma d-lactic acid and endotoxin levels were increased in both groups 1 d after surgery,but those in the observation group were lower than those in the control group(P<0.05).CD3^+and CD4^+levels were decreased and CD8^+levels were increased in both groups 1 d after surgery,but CD3^+and CD4^+levels in the observation group were higher than those in the control group,and CD8^+levels were lower than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion Dexmedetomidine can protect the immune and intestinal mucosal barrier function of patients undergoing laparoscopic radical resection of colon cancer.