| 彭 隽,李淑虹,初春琴,林志豪,刘英志.右美托咪定联合依托咪酯对老年直肠癌根治术患者血液微转移、胃肠功能恢复和认知功能的影响[J].,2023,(11):2108-2112 |
| 右美托咪定联合依托咪酯对老年直肠癌根治术患者血液微转移、胃肠功能恢复和认知功能的影响 |
| Effects of Dexmedetomidine Combined with Etomidate on Blood Micrometastasis, Gastrointestinal Function Recovery and Cognitive Function in Elderly Patients Undergoing Radical Resection of Rectal Cancer |
| 投稿时间：2022-10-06 修订日期：2022-10-28 |
| DOI：10.13241/j.cnki.pmb.2023.11.021 |
| 中文关键词: 右美托咪定 依托咪酯 老年 直肠癌根治术 血液微转移 胃肠功能 认知功能 |
| 英文关键词: Dexmedetomidine Etomidate Elderly Radical resection of rectal cancer Blood micrometastasis Gastrointestinal function Cognitive function |
| 基金项目:山东省自然科学基金项目（ZR2016HM81） |
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| 中文摘要: |
| 摘要 目的：探讨老年直肠癌根治术患者麻醉中使用右美托咪定联合依托咪酯，机体血液微转移、胃肠功能恢复和认知功能的变化情况。方法：根据随机数字表法将我院2020年4月~2022年2月期间收治的112例老年直肠癌根治术患者分为对照组（n=56，依托咪酯麻醉）和研究组（n=56，右美托咪定联合依托咪酯麻醉）。对比两组血液微转移情况、血流动力学、麻醉效果、胃肠功能恢复情况和认知功能情况，统计两组不良反应发生情况。结果：两组术后24 h角蛋白20（CK20）阳性表达率均降低，且研究组低于对照组（P<0.05）。两组不良反应发生率组间对比无差异（P>0.05）。研究组插管即刻、术毕即刻、拔管即刻心率（HR）、平均动脉压（MAP）均高于对照组（P<0.05）。两组气管拔管时间、呼吸恢复时间、麻醉苏醒时间组间对比差异不明显（P>0.05）。研究组进食时间、首次排气时间、肠鸣音恢复时间均较对照组更短（P<0.05）。研究组术后1 d、术后3 d简易精神状态检查量表（MMSE）评分高于对照组，术后认知功能障碍（POCD）发生率低于对照组（P<0.05）。结论：依托咪酯联合右美托咪定用于老年直肠癌根治术患者，麻醉效果较好，可维持血流动力学稳定，降低血液微转移，改善胃肠功能和认知功能。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the changes of blood micrometastasis, gastrointestinal function recovery and cognitive function in elderly patients undergoing radical resection of rectal cancer during anesthesia with dexmedetomidine and etomidate. Methods: 112 cases of elderly patients undergoing radical resection of rectal cancer who were treated in our hospital from April 2020 to February 2022 were divided into control group (n=56, etomidate anesthesia) and study group (n=56, dexmedetomidine combined with etomidate anesthesia) according to the random number table method. The blood micrometastasis situation, hemodynamics, anesthetic effect, gastrointestinal function recovery situation and cognitive function situation were compared between the two groups, and the incidence of adverse reactions in the two groups was counted. Results: The positive expression rate of cyctokeratin-20 (CK20) in the two groups at 24 h after operation was decreased, and study group was lower than control group (P<0.05). There was no difference in incidence rate of adverse reactions between two groups (P>0.05). The heart rate (HR) and mean arterial pressure (MAP) in the study group at immediately intubation, immediately after operation and immediately extubation were higher than those in the control group(P<0.05). There were no significant differences in the tracheal extubation time, respiratory recovery time and anesthesia recovery time in both groups (P>0.05). The feeding time, intestinal sound recovery time and first exhaust time in the study group were shorter than those in the control group (P<0.05). The Mini-Mental State Examination (MMSE) scores in the study group at 1 d after operation and 3 d after operation were higher than those in the control group, the incidence rate of postoperative cognitive dysfunction (POCD) was lower than that in control group (P<0.05). Conclusion: Etomidate combined with Dexmedetomidine in elderly patients undergoing radical resection of rectal cancer has a good anesthetic effect, which can maintain hemodynamic stability, reduce blood micrometastasis, improve gastrointestinal function and cognitive function. |
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