| 翁瑞文,张转运,杨许丽,吴 迪,刘小霞.右美托咪定联合依托咪酯对老年直肠癌根治术患者术后炎症反应、胃肠功能恢复和认知功能的影响[J].,2022,(7):1252-1256 |
| 右美托咪定联合依托咪酯对老年直肠癌根治术患者术后炎症反应、胃肠功能恢复和认知功能的影响 |
| Effects of Dexmedetomidine Combined with Etomidate on Postoperative Inflammatory Response, Gastrointestinal Function Recovery and Cognitive Function in Elderly Patients Undergoing Radical Resection of Rectal Cancer |
| 投稿时间：2021-09-06 修订日期：2021-09-30 |
| DOI：10.13241/j.cnki.pmb.2022.07.012 |
| 中文关键词: 右美托咪定 依托咪酯 老年 直肠癌根治术 炎症反应 胃肠功能 认知功能 |
| 英文关键词: Dexmedetomidine Etomidate Elderly Radical resection of rectal cancer Inflammatory response Gastrointestinal function Cognitive function |
| 基金项目:国家自然科学基金项目（81701102） |
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| 中文摘要: |
| 摘要 目的：探讨右美托咪定联合依托咪酯对老年直肠癌根治术患者术后炎症反应、胃肠功能恢复和认知功能的影响。方法：选择2019年3月~2021年5月南京鼓楼医院收治的180例老年直肠癌患者，均接受腹腔镜下直肠癌根治术治疗。根据随机数字表法将患者分为对照组和研究组，各为90例。对照组患者麻醉选用依托咪酯，研究组患者麻醉选用右美托咪定联合依托咪酯，对比两组术中血流动力学、术后炎症反应、胃肠功能恢复和认知功能，同时记录两组围麻醉期不良反应发生情况。结果：插管即刻（T2）~拔管即刻（T4）时间点，两组心率（HR）、平均动脉压（MAP）先下降后升高，且研究组的波动幅度小于对照组（P<0.05）。两组进食时间组间对比无统计学差异（P>0.05），研究组的肠鸣音恢复时间、首次排气时间短于对照组（P<0.05）。两组气管拔管时间、呼吸恢复时间、麻醉苏醒时间对比无统计学差异（P>0.05）。两组术后3 d白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）和C反应蛋白（CRP）水平均升高，且研究组的变化幅度小于对照组（P<0.05）。两组术后1 d、术后3 d简明智能状态量表（MMSE）评分先下降后升高，且研究组的波动幅度小于对照组（P<0.05）。两组不良反应发生率组间对比无差异（P>0.05）。结论：老年直肠癌根治术患者麻醉方案选用右美托咪定联合依托咪酯，可减轻机体炎性应激，稳定机体血流动力学，有利于胃肠功能恢复，同时还可减轻对机体认知功能的损害。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of dexmedetomidine combined with etomidate on postoperative inflammatory response, gastrointestinal function recovery and cognitive function in elderly patients undergoing radical resection of rectal cancer. Methods: 180 elderly patients with rectal cancer who were treated in Nanjing Drum Tower Hospital from March 2019 to may 2021 were selected, all patients underwent laparoscopic radical resection of rectal cancer. According to the random number table method, the patients were divided into control group and study group, with 90 cases in each group. Etomidate was used for anesthesia in the control group, and dexmedetomidine combined with etomidate was used in the study group. The hemodynamics, postoperative inflammatory reaction, gastrointestinal function recovery and cognitive function of the two groups were compared, and the occurrence of perioperative adverse reactions of the two groups were recorded. Results: At the time point from the moment of intubation (T2) ~ the moment of extubation (T4), heart rate (HR) and mean arterial pressure (MAP) decreased first and then increased in the two groups, and the fluctuation range of the study group was less than that of the control group (P<0.05). There was no significant difference between the two groups in eating time (P>0.05). The recovery time of bowel sounds and the first exhaust time of the study group were shorter than those of the control group (P<0.05). There were no significant differences in tracheal extubation time, respiratory recovery time and anesthesia recovery time between the two groups (P>0.05). The levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) increased, and the fluctuation range of the study group was less than that of the control group (P<0.05). The Mini-Mental State Examination (MMSE) scores of the two groups decreased first and then increased at 1d and 3d after operation, and the fluctuation range of the study group was less than that of the control group (P<0.05). There was no difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Dexmedetomidine combined with etomidate in elderly patients undergoing radical resection of rectal cancer can reduce the inflammatory stress of the body, stabilize the hemodynamics, be conducive to the recovery of gastrointestinal function, and reduce the damage to the cognitive function of the body. |
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