右美托咪定复合瑞芬太尼对食管癌根治术患者应激反应的影响
Effect of dexmedetomidine combined with remifentanil on stress response in patients undergoing radical resection for esophageal cancer
陈龙 1谢宏伟 1候俊峰1
作者信息
- 1. 周口市中心医院麻醉科,河南周口 466000
- 折叠
摘要
目的 探讨右美托咪定复合瑞芬太尼对食管癌根治术患者应激反应的影响.方法 选择2021年3月至2023年3月周口市中心医院接诊的行食管癌根治术的患者90例,随机均分为对照组和观察组2组,每组45例.对照组采取瑞芬太尼静脉麻醉,观察组采用右美托咪定复合瑞芬太尼静脉麻醉.比较2组患者麻醉相关指标、应激反应相关指标及不良反应发生情况.结果 与对照组比较,观察组瑞芬太尼使用剂量减少,苏醒时间、拔管时间均缩短(t=35.240,P＜0.001;t=11.810,P＜0.001;z=10.340,P＜0.001).观察组患者术后3 d血清促肾上腺皮质激素、皮质醇水平均低于对照组(t=7.622,P＜0.001;t=4.467,P＜0.001).观察组不良反应发生率低于对照组(x2=4.406,P=0.036).结论 右美托咪定复合瑞芬太尼减少了食管癌根治术患者麻醉药物的剂量,减轻了应激反应,且安全性高,具有较高的临床推广价值.
Abstract
Objective To probe the effect of dexmedetomidine combined with remifentanil on stress response in pa-tients undergoing radical resection for esophageal cancer.Methods A total of 90 patients admitted to Zhoukou Central Hospital from March 2021 to March 2023 who underwent radical resection for esophageal cancer were arbitrarily grouped into the control group(n=45)and the observation groups(n=45).Patients in the control group were given intravenous anes-thesia with remifentanil,and patients in the observation group were given intravenous anesthesia with dexmedetomidine com-bined with remifentanil.The anesthesia-related indexes,immune function,stress response and toxicities were compared be-tween the two groups.Results Compared with the control group,the dose of remifentanil in the observation group was prominently lessened,and the awakening and the extubation time were prominently cut down(t=35.240,P＜0.001;t=11.810,P＜0.001;t=10.340,P＜0.001).Compared with the control group,the serum ACTH and COR levels in the observation group were dramatically lessened 3 days after operation(t=7.622,P＜0.001;t=4.467,P＜0.001).Com-pared with the control group,the adverse reaction rate in the observation group was prominently lessened(x2=4.406,P=0.036).Conclusion Dexmedetomidine combined with remifentanil could lessen the dose of anesthetic drugs in patients undergoing radical resection of esophageal cancer,reduce the stress response,have high safety,and have high clinical pro-motion value.
关键词
食管癌根治术/麻醉/右美托咪定/瑞芬太尼/血流动力学/应激反应Key words
radical resection of esophageal carcinoma/anesthesia/dexmedetomidine/remifentanil/hemodynam-ics/stress response引用本文复制引用
出版年
2024
NETL
NSTL
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