右美托咪定对结直肠癌根治术患者的肠保护作用及机体氧化应激反应的影响

Intestinal Protection of Dexmedetomidine on Patients Undergoing Radical Resection of Colorectal Cancer and the Effect of Oxidative Stress in the Body

目的:探讨右美托咪定对结直肠癌根治术患者的肠保护作用及机体氧化应激反应影响。方法:选取2017年5月-2020年4月于本院进行手术的122例结直肠癌根治术患者,根据随机信封抽签原则分为观察组和对照组,每组61例。对照组术前给予生理盐水并给予丙泊酚进行麻醉维持,观察组术前给予右美托咪定并给予右美托咪定进行麻醉维持。比较两组围术期指标、并发症发生情况,比较两组术前和术后1、7 d的血清SOD、MDA、CD4^(+)、CD8^(+)水平。结果:两组的术中出血量和手术时间比较,差异均无统计学意义(P>0.05);观察组的术后肛门排气时间、肛门排便时间、首次下床活动时间、住院时间均短于对照组,差异均有统计学意义(P<0.05)。观察组并发症发生率为3.3%低于对照组的13.1%,差异有统计学意义(P<0.05)。术前,两组SOD、MDA比较,差异均无统计学意义(P>0.05)。术后1 d,两组SOD均低于术前,MDA均高于术前,差异均有统计学意义(P<0.05)。术后7 d,两组SOD、MDA与术前比较,差异均无统计学意义(P>0.05)。术后7 d,两组SOD均高于术后1 d,MDA均低于术后1 d,差异均有统计学意义(P<0.05)。术后1 d,观察组的SOD高于对照组,MDA低于对照组,差异均有统计学意义(P<0.05)。术后7 d,两组SOD、MDA比较,差异均无统计学意义(P>0.05)。术前,两组CD4^(+)、CD8^(+)比较,差异均无统计学意义(P>0.05)。术后1、7 d,两组CD4^(+)、CD8^(+)均低于术前,差异均有统计学意义(P<0.05)。术后7 d,两组CD4^(+)高于术后1 d,差异均有统计学意义(P<0.05);两组CD8^(+)均高于术后1 d,差异均无统计学意义(P>0.05)。术后1、7 d,观察组CD4^(+)高于对照组,差异有统计学意义(P<0.05);观察组CD8^(+)高于对照组,差异无统计学意义(P>0.05)。结论:右美托咪定在结直肠癌根治术患者中应用能发挥肠保护作用,维持机体氧化应激反应平衡,提高患者的免疫功能,促进患者康复。

Objective:To investigate the intestinal protection of Dexmedetomidine on patients undergoing radical resection of colorectal cancer and the effect of oxidative stress in the body.Method:A total of 122 patients with radical resection of colorectal cancer in our hospital from May 2017 to April 2020 were selected,and they were divided into observation group and control group according to the principle of random envelope lottery,61 cases in each group.The control group was given preoperative normal saline and Propofol for anesthesia maintenance,and the observation group was given preoperative Dexmedetomidine and Dexmedetomidine for anesthesia maintenance.The perioperative indexes,the incidence of complications were compared between two groups,SOD,MDA,CD4^(+) and CD8^(+) levels in serum before and 1,7 d after surgery were compared between two groups.Result:There were no significant differences in the amount of intraoperative blood loss and surgical time between two groups (P>0.05);the postoperative anal exhaust time,anal defecation time,first time out of bed activity time and hospitalization time of observation group were shorter than those of control group,and the differences were statistically significant (P<0.05).The incidence of complications of observation group was 3.3% lower than 13.1% of control group,and the difference was statistically significant (P<0.05).Before surgery,there were no significant differences in SOD and MDA between two groups (P>0.05).At 1 d after surgery,SOD of both groups were lower than those before surgery,while MDA were higher than that before surgery,the differences were statistically significant (P<0.05).At 7 d after surgery,there were no significant differences in SOD and MDA between two groups compared with those before surgery (P>0.05).At 7 d after surgery,SOD of both groups were higher than that those of 1 d after surgery,and MDA of both groups were lower than those of 1 d after surgery,the differences were statistically significant (P<0.05).At 1 d after surgery,the SOD of the observation group was higher than that of the control group,while the MDA of the observation group was lower than that of the control group,the differences were statistically significant (P<0.05).At 7 d after surgery,there were no significant differences in SOD and MDA between two groups (P>0.05).Before surgery,there were no significant differences in CD4^(+) and CD8^(+) between two groups (P>0.05).1 and 7 d after surgery,CD4^(+) and CD8^(+) of both groups were lower than those before surgery,the differences were statistically significant (P<0.05).At 7 d after surgery,CD4^(+) of both groups were higher than those of 1 d after surgery,the differences were statistically significant (P<0.05);CD8^(+) of both groups were higher than those of 1 d after surgery,and the differences were not statistically significant (P>0.05).At 1 and 7 d after surgery,CD4^(+) of observation group were higher than those of control group,the differences were statistically significant (P<0.05);CD8^(+) of the observation group were higher than those of the control group,and the differences were not statistically significant (P>0.05).Conclusion:The application of Dexmedetomidine in patients undergoing radical resection of colorectal cancer can play a protective role in intestinal protection,maintain the balance of oxidative stress response,improve the immune function of patients and promote the recovery of patients.