右美托咪定对食管癌患者术后苏醒期睡眠质量、认知功能的影响

Effects of Dexmedetomidine on Sleep Quality and Cognitive Function in Patients with Esophageal Cancer after Awakening

目的:探究右美托咪定对食管癌患者术后苏醒期睡眠质量、认知功能的影响。方法:选取2021年1月至2022年1月于厦门大学附属第一医院进行手术治疗的食管癌患者100例作为研究对象,随机分为对照组和观察组,每组50例。2组患者分别进行麻醉干预,分析2组患者的苏醒质量,检测2组患者围术期各时间点血压、心率水平,检测麻醉前后血气指标变化情况,酶标分析仪检测应激指标MDA、Cor水平,对2组患者的睡眠质量、认知功能变化进行比较。结果:与对照组比较,观察组患者苏醒时间较短,躁动评分较低,Ramay评分较高,差异有统计学意义(P<0.05)。T_(1)、T_(2)、T_(3)时,观察组患者SBP、DBP、HR水平低于对照组(P<0.05)。麻醉后,与对照组比较,观察组患者pH水平较高,CO_(2)总量、CO_(2)分压水平较低,差异有统计学意义(P<0.05)。麻醉后,2组患者MDA、Cor水平均上升,且观察组患者MDA、Cor水平低于对照组(P<0.05)。术后1 d、术后2 d,观察组PSQI评分低于对照组,MMSE评分高于对照组(P<0.05)。结论:食管癌患者围术期使用右美托咪定进行干预,能够提升患者的苏醒质量,使其生命体征、血气水平稳定,手术应激反应较轻,进而改善其睡眠质量,降低其认知功能受损程度,有利于其术后恢复。

Objective:To investigate the effects of dexmedetomidine on sleep quality and cognitive function in patients with esophageal cancer after awakening.Methods:A total of 100 patients with esophageal cancer who underwent surgical treatment in The First Affiliated Hospital of Xiamen University from January 2021 to January 2022 were selected and randomly divided into control group and observation group,50 patients in each group,respectively,for anesthesia intervention.Two groups of patients underwent anesthesia intervention,analyzing their awakening quality,detecting blood pressure and heart rate levels at various time points during the perioperative period,detecting changes in blood gas indicators before and after anesthesia,and detecting stress indicators MDA and Cor levels with an enzyme labeling analyzer.The changes in sleep quality and cognitive function of the two groups of patients were compared.Results:Compared with the control group,observation group had shorter awakening time,lower agitation score and higher Ramay score and the difference was statistically significant(P<0.05).At T_(1),T_(2) and T_(3),SBP,DBP and HR levels in observation group were lower than those in control group(P<0.05).After anesthesia,compared with the control group,observation group had higher pH level,lower total CO_(2) and CO_(2) partial pressure level and the difference was statistically significant(P<0.05).After anesthesia,the levels of MDA and Cor in both groups were increased,and the levels of MDA and Cor in observation group were lower than those in control group(P<0.05).1 d and 2 d after surgery,PSQI score of observation group was lower than control group,MMSE score was higher than control group(P<0.05).Conclusion:Perioperative intervention with dexmedetomidine in patients with esophageal cancer can improve the quality of patients′recovery,with stable vital signs and blood gas levels,mild surgical stress response,improved sleep quality and mild cognitive impairment,which is conducive to postoperative recovery of patients.