右美托咪定对腹腔镜下子宫切除术患者微循环及应激水平的影响

目的 研究右美托咪定对腹腔镜下子宫切除术患者微循环及应激水平的影响。方法 选择择期行子宫切除术的患者70例，随机分成A、B两组，A组为安慰剂组（10mL生理盐水），B组为右美托咪定组（1．0μg／kg）。记录麻醉诱导前（T0）、插管后（T1）、切皮后（T2）、术毕（T3）和拔管后（T4）的平均动脉压（MAP）、心率以及血中皮质醇（Cor）、肾上腺素（E）、去甲肾上腺素（NE）以及β-内啡肽的浓度，分析它们是否有差异。结果 相比于T0时刻，A组患者T1、T2、T3和T4时刻的MAP和HR都有明显升高（P〈0．05），而B组患者的MAP和HR差异无统计学意义（P〉0．05）。A组在T1、T2、T3和T4时刻的Cor、E、NE和β-内啡肽值均高于T0时刻值（P〈0．05），而B组除了Cor在T2、T3和T4时刻高于T0时刻（P〈0．05）外，其他三个指标在五个时间点差异无统计学意义（P〉0．05）。结论 右美托咪定能维持手术期患者血流动力学稳定，降低手术期机体应激反应强度。

Effect of microcirculation and perioperative stress response of Dexmedetomidine to the hysterectomy patients

Objective To investigate the efficacy of microcirculation and perioperative stress response of Dexmedetomidine to the hysterectomy patients. Methods 70 patients scheduled for hysterectomy were randomly divided into two groups： group A （10 mL normal saline） and group B （1.0 μg/kg Dexmedetomidine）. Mean artery pressure （MAP）, heart rate （HR）, the levels of cortisol （Cor）, epinephrine （E）, norepinephrine （NE） and β-endorphin were record before given Dexmedetomidine infusion （T0）, after tracheal intubation （T1）, after skin incision （T2）, at the end of surgery （T3） and after tracheal intubation （T4）, and then analyzed whether there were significant differences. Results In group A, MAP and HR at the time of T1, T2, T3 and T4 were significant higher than that at the time of To （P 〈 0.05）, but there was no significant different in group B （P 〉 0.05）. In group A, the levels of Cor, E, NE and β-endorphin at the time of T1, T2, T3 and T4 were significant higher than that at the time of T0 （P 〈 0.05）, and only the level of Cor at the time of T2, T3 and T4 were significant higher than that at the time of T0 in group B （P 〈 0.05）, the other indexes in the five time had no significant differences （P 〉 0.05）. Conclusion Dexmedetomidine can maintain the hemodynamic stability of surgical patients, and reduce the patients＇ stress response.