【摘要】 目的探讨右美托咪定联合丙泊酚全凭静脉麻醉对右半结肠癌患者的麻醉效果。方法选取2018年10月至2020年10月鄢陵县人民医院拟行择期右半结肠癌手术患者88例,按随机数表法分为Ⅰ组（44例）和Ⅱ组（44例）。Ⅰ组接受丙泊酚、芬太尼静脉麻醉,Ⅱ组接受右美托咪定、丙泊酚静脉麻醉。观察两组术后5 min（t₁）、10 min（t₂）、15 min（t₃）Ramsay评分及注射丙泊酚前（T₀）、注射丙泊酚后（T₁）、苏醒时（T₂）3个时间点的血流动力学指标[平均动脉压（MAP）、心率（HR）]变化,并统计对比氧化指标[脂质过氧化物（LPO）、谷胱甘肽过氧化物酶（GSH-PX）、铜锌超氧化物歧化酶（Cu-Zn SOD）]、不良反应发生率。结果Ⅰ组起效时间、麻醉苏醒时间短于Ⅱ组（P<0.05）;术后Ⅰ组t₁、t₂、t₃ Ramsay评分低于Ⅱ组（P<0.05）;Ⅰ组T₂ HR、MAP低于Ⅱ组（P<0.05）;拔管后Ⅰ组LPO、GSH-PX低于Ⅱ组（P<0.05）;Ⅰ组不良反应发生率低于Ⅱ组（P<0.05）。结论右美托咪定联合丙泊酚在右半结肠癌患者全凭静脉麻醉中起效时间快,能缩短术后苏醒时间,减轻应激反应,且镇静效果明显。更多还原

【Abstract】 Objective To explore the effect of total intravenous anesthesia with dexmedetomidine combined with propofol in patients with right colon cancer.Methods A total of 88 patients with elective right colon cancer surgery in Yanling People’s Hospital from October 2018 to October 2020 were selected and randomly divided into group Ⅰ（44 cases） and group Ⅱ（44 cases）. Group Ⅰ was given intravenous anesthesia with propofol and fentanyl, and group Ⅱ was given intravenous anesthesia with dexmedetomidine and propofol. The Ramsay scores of the two groups were observed at 5 min（t₁）, 10 min（t₂）, 15 min（t₃） after the operation. Changes in hemodynamic indicators [mean arterial pressure（MAP）, heart rate（HR）] of the two groups were observed before the injection of propofol（T₀）, after the injection of propofol（T₁） and at the time of recovery（T₂）. Oxidation indicators [lipid peroxide（LPO）, glutathione peroxidase（GSH-PX）, Cu-Zn superoxide dismutase（Cu-Zn SOD）] and the incidence of adverse reactions of the two groups were compared.Results The onset time and awakening time from anesthesia in group Ⅰ were lower than those in group Ⅱ（P<0.05）. The Ramsay scores in group Ⅰ were lower than those in group Ⅱ at t₁, t₂, and t₃（P<0.05）. HR, MAP in group Ⅰwas lower than group Ⅱ at T₂（P<0.05）. After extubation, LPO and GSH-PX in group Ⅰ were lower than group Ⅱ（P<0.05）. The incidence of adverse reactions in group Ⅰ was lower than that in group Ⅱ（P<0.05）.Conclusion Dexmedetomidine combined with propofol has a fast onset time in patients with right colon cancer under intravenous anesthesia, which can shorten the postoperative recovery time, reduce the stress response, and has a significant sedative effect.更多还原