【摘要】 目的观察右美托咪定用于结肠癌伴轻度肝功能异常根治术患者复合麻醉中的效果。方法选取86例伴轻度肝功能异常的结肠癌患者为研究对象,随机分为观察组与对照组,每组各43例。两组均行开腹根治术,采取丙泊酚、瑞芬太尼复合麻醉,观察组麻醉前预注右美托咪定0.4μg/kg,并以0.2μg/（kg·h）的剂量维持静脉输注。比较两组丙泊酚用量、苏醒时间、拔管时间、麻醉前1 h与拔管即刻的血清总胆红素（TBIL）水平及术中不同时点的血浆肾上腺素（E）及去甲肾上腺素（NE）浓度,比较不良反应总发生率。结果两组苏醒时间、拔管时间与麻醉前后TBIL差异均无统计学意义（P>0.05）。观察组丙泊酚用量为（997.54±64.22）mg,低于对照组（P<0.05）。观察组t₁、t₂、t₃时刻的E与NE浓度均下降,低于t0时刻（P<0.05）,对照组t₂时刻的E与NE均升高,高于t0时刻（P<0.05）。观察组t₂、t₃时刻的E与t₁、t₂、t₃时刻的NE均低于对照组（P<0.05）。观察组不良反应总发生率为11.63%,低于对照组的30.23%（P<0.05）。结论右美托咪定在结肠癌伴轻度肝功能异常根治术患者中的应用有助于维持术中血流动力学稳定性,减少丙泊酚用量及不良反应。更多还原

【Abstract】 Objective To study the effect of dexmedetomidine in anesthesia in patients with colon cancer and mild abnormal liver function. Methods 86 patients with colon cancer and mild liver dysfunction were selected and assigned to treatment group and control group according to the random number table,with 43 cases in each group. Both groups were treated with open radical surgery and propofol and remifentanil combined anesthesia. The deemethomidine were pre-infused with 0.4 μg/kg in the treatment group before anesthesia,and intravenous infusion was maintained at the dose of 0.2 μg/kg. The dosage of propofol,time to recovery,time to extubation,serum levels of total bilirubin（TBIL）one hour before anesthesia and immediately after extubation,and levels of plasma adrenaline（E）and norepinephrine（NE）at different time points were compared between the two groups. Results There was no significant difference between the two groups in the time to recovery,time to extubation and TBIL before and after anesthesia（P > 0.05）. The dosage of propofol in the treatment group was（997.54±64.22） mg,which was lower than that in the control group（P < 0.05）. The levels of E and NE in the treatment group at t₁,t₂ and t₃ decreased compare to t₀. The levels of E and NE at t₂ in the control group were higher than those at t₀（P < 0.05）. The level of E at t₂ and t₃ and the levels of NE at t₁,t₂ and t₃ were lower in the treatment group than those in control group（P < 0.05）. The total incidence of adverse reactions in the treatment group was 11.63%,which was lower than that in the control group（30.23%,P < 0.05）. Conclusion Use of dexmedetomidine in anesthesia in patients with colon cancer and mild liver dysfunction helps to maintain intraoperative hemodynamic stability,reduce dosage of propofol and adverse reactions. It is feasible to implement.更多还原