右美托咪啶对腹腔镜胆囊切除患者红细胞变形性的影响

目的 探讨右美托咪啶对腹腔镜胆囊切除患者红细胞变形性的影响.方法 选取我院择期行腹腔镜胆囊切除术患者40例,按随机数字表法分为2组：右美托咪啶组（D组）和对照组（C组）,每组20例.2组患者采用相同的麻醉方式,D组在诱导前给予右美托咪啶0.5 μg/kg的负荷量泵注10 min,随后改为0.5 μg·kg-1·h-1持续至气腹结束;C组在相同时间给予等量的生理盐水,静脉泵入至气腹结束.记录麻醉前（T0）以及手术结束时（T1）红细胞变形指数（EI）和血细胞比容（Hct）,手术时间、术中失血量以及麻醉药用量.结果 C组T1时EI（0.90±0.04）较T0时EI（0.81±0.06）显著增高,差异有统计学意义（P〈0.05）;D组T1时EI（0.85±0.06）较T0时EI（0.82±0.07）有所升高,但差异无统计学意义（P〉0.05）.D组瑞芬太尼和丙泊酚用量与C组相比显著减少（P〈0.05）.结论 腹腔镜胆囊切除术中使用右美托咪啶可以改善患者红细胞变形能力,减少患者术中以及术后并发症,改善患者远期预后.

Effects of dexmedetomidine on the deformability of erythrocyte in patients with laparoscopic cholecystectomy

Objective To study the impact of dexmedetomidine on the deformability of erythrocyte in patients with laparoscopic cholecystectomy. Methods 40 patients scheduled for laparoscopic choleeysteetomy were randomly divided into 2 groups （ n = 20 each） ： dexmedetomidine group （ group D, 0.5 txg/kg loading within 10 min and 0.5 μg·kg-1·h-1 maintenance to the end of pneumoperitoneum） and control group （group C, normal saline administered in the same way）. The induction and maintenance of anesthesia of 2 groups were identical. Erythrocyte deformability index （EI） and hematocrit （Hct） were assayed before anesthesia （T0 ） and after the operation （T1 ）. Operation time, intraoperation blood loss and the amount of anesthetics were recorded. Results Compared with TO （ 0.81 ±0.06） , EI was significantly increased at T1 in group C （P 〈 0.05）. Compared with TO （0.82 ±0.07）, EI was increased at T1 in group D, but it showed no statistically significant difference （ P 〉 0.05 ）. Compared with group C, the consumption of remifentanil and propofol were significantly reduced in group D （ P 〈 0.05 ）. Conclusions Densmedetomidine can improve the deform- ability of erythrocyte, reduce intraoperative and postoperative complications and improve the long - term prognosis of pa- tients.