右美托咪定辅助全身麻醉在胃癌根治术中的效果及对磷酸果糖激酶、醛糖还原酶、葡萄糖-6-磷酸脱氢酶及血流动力学的影响

Effects of dexmedetomidine assisted general anesthesia in radical gastrectomy and phosphofructokinase,aldose reductase,glucose-6-phosphate dehydrogenase and hemodynamics

目的 探讨右美托咪定辅助全身麻醉在胃癌根治术中的麻醉效果及对磷酸果糖激酶(phosphofructokinase,PFK)、醛糖还原酶(aldose reductase,AR)、葡萄糖-6-磷酸脱氢酶(glucose 6-phosphate dehydrogenase,G6PD)及血流动力学的影响。方法 选择2018年12月至2020年12月于青岛市市立医院接受胃癌根治术的101例患者,根据麻醉方式分为观察组(51例)和对照组(50例)。对照组采用常规全身麻醉,观察组在麻醉诱导前给予右美托咪定。比较两组麻醉效果、手术前后PFK、AR、G6PD、心率(heart rate,HR)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)水平变化、通气时间、进流食时间、下床时间及术后住院时间及并发症发生情况。结果 观察组(96.08%)总优良率较对照组(82.00%)高,差异有统计学意义(P<0.05)。术后,两组血清PFK均随时间推移而降低,且观察组高于对照组(P<0.05);两组AR、G6PD水平均随时间推移而升高,且观察组低于对照组(P<0.05)。两组HR、SBP、DBP均随时间推移而降低,且观察组高于对照组(P<0.05)。观察组通气时间、进流食时间、下床时间及术后住院时间均低于对照组,差异均有统计学意义(P<0.05)。观察组和对照组并发症总发生率分别为1.96%、16.00%,组间比较差异有统计学意义(P<0.05)。结论 胃癌根治术患者应用右美托咪定辅助全身麻醉效果显著,可有效改善PFK、AR、G6PD及血流动力学水平,安全有效。

Objective To investigate the anesthetic effects of dexmedetomidine assisted general anesthesia in radical gastrectomy for gastric cancer and its effect on phosphofructokinase(PFK) and aldose reductase(AR),glucose-6-phosphate dehydrogenase(G6PD) and hemodynamics.Methods A total of 101 patients who underwent radical gastrectomy in Qingdao municipal hospital from December 2018 to December 2020 were retrospectively analyzed.The patients were divided into observation group(51 cases) and control group(50 cases) according to the anesthesia method.The control group was given conventional general anesthesia,while the observation group was given dexmedetomidine before induction of anesthesia.The anesthetic effect,PFK,AR,G6PD,heart rate (HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),ventilation time,feeding time,getting out of bed time,postoperative hospital stay and complications before and after operation were compared between the two groups.Results The total excellent and good rate of the observation group(96.08%) was higher than that of the control group(82.00%),and the difference was statistically significant(P<0.05).After operation,serum PFK in the two groups decreased with time,and the observation group was higher than that in the control group(P<0.05).The levels of AR and G6PD in the two groups increased with time,and the observation group were lower than those in the control group(P<0.05).HR,SBP and DBP of the two groups were decreased with time,and the observation group were higher than those of the control group(P<0.05).The ventilation time,fluid feeding time,getting out of bed time and postoperative hospital stay in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the observation group and the control group were 1.96% and 16.00%,respectively,and the difference was statistically significant(P<0.05).Conclusions The application of dexmedetomidine in patients undergoing radical gastrectomy has a significant effect,which can improve PFK,AR,G6PD and hemodynamics,and is safe and effective.