右美托咪定辅助全身麻醉对胃癌根治术患者围术期血流动力学及肺功能的影响探讨

Effect of dexmedetomidine assisted general anesthesia on perioperative hemodynamics and lung function in patients with radical gastric cancer surgery

目的 研究胃癌根治术患者应用全身麻醉联合右美托咪定对血流动力学及肺功能的影响。方法 60例胃癌根治术患者为研究对象,依据随机单盲法分为观察组与对照组,各30例。对照组采用全身麻醉,观察组在对照组基础上应用右美托咪定注射液。比较两组血流动力学指标、肺部感染发生情况及肺功能指标。结果 麻醉诱导前、切片时、手术结束时,观察组心率分别为(73.5±5.2)、(70.6±4.9)、(67.2±4.6)次/min,高于对照组的(70.5±4.8)、(65.2±4.5)、(63.2±4.2)次/min,平均动脉压分别为(96.2±8.0)、(89.1±6.2)、(94.7±6.9)mm Hg(1 mm Hg=0.133 kPa),高于对照组的(92.3±6.4)、(85.3±5.6)、(89.2±6.5)mm Hg,差异有统计学意义(P<0.05)。观察组肺部感染发生率3.33%低于对照组的20.00%,差异有统计学意义(P<0.05)。观察组最大通气量(MVV)/第1秒用力呼气容积(FEV1)(79.5±7.3)%、[MVV-每分钟静息通气量(VE)]/FEV1(84.5±5.6)%高于对照组的(73.4±7.0)%、(79.5±5.2)%,残气量(RV)/肺总量(TLC)(33.1±4.2)%低于对照组的(37.4±4.5)%,差异有统计学意义(P<0.05)。结论 胃癌根治术中应用右美托咪定辅助全身麻醉的效果比较理想,可稳定患者血流动力学,改善肺功能,减少肺部感染等情况,具备优势。

Objective To study the effect of dexmedetomidine assisted general anesthesia on perioperative hemodynamics and lung function in patients with radical gastric cancer surgery.Methods A total of 60 patients with radical gastric cancer surgery were divided into observation group and control group according to randomized single-blind method,with 30 cases in each group.The control group was given general anesthesia,and the observation group was given dexmedetomidine injection on the basis of the control group.The hemodynamic indexes,pulmonary infection and pulmonary function indexes were compared between the two groups.Results Before anesthesia induction,at sectioning,and at the end of surgery,the heart rate of the observation group were(73.5±5.2),(70.6±4.9),and(67.2±4.6)beats/min,which were higher than those of(70.5±4.8),(65.2±4.5),and(63.2±4.2)beats/min of the control group;the mean arterial pressure of the observation group were(96.2±8.0),(89.1±6.2),and(94.7±6.9)mm Hg(1 mm Hg=0.133 kPa),which were higher than those of(92.3±6.4),(85.3±5.6),and(89.2±6.5)mm Hg of the control group;the differences were statistically significant(P<0.05).The incidence of pulmonary infection in the observation group was 3.33%,which was lower than that of 20.00%in the control group,and the difference was statistically significant(P<0.05).The maximum ventilation volume(MVV)/forced expiratory volume in one second(FEV1)of(79.5±7.3)%and MVV-minute ventilation(VE)/FEV1 of(84.5±5.6)%in the observation group were higher than those of(73.4±7.0)%and(79.5±5.2)%in the control group;the residual volume(RV)/total lung capacity(TLC)of(33.1±4.2)%in the observation group was lower than that of(37.4±4.5)%in the control group;the differences were statistically significant(P<0.05).Conclusion In patients undergoing radical gastric cancer surgery,the adjuvant use of dexmedetomidine during general anesthesia has a relatively ideal effect,which has advantages in stabilizing hemodynamics,improving pulmonary function,and reducing the occurrence of pulmonary infection.