右美托咪定对腹腔镜下直肠癌根治术后患者早期认知功能障碍的影响

目的观察腹腔镜下直肠癌根治术对患者的早期认知功能障碍的影响和右美托咪定的干预作用。方法随机将80例在本院外科住院,ASAⅠ-Ⅱ拟行腹腔镜下根治术的直肠癌患者分为右美托咪定组（D组）和生理盐水对照组（C组）,在手术前和手术后分别给予持续性泵注右美托咪定和生理盐水,并于术后观察两组患者的早期认知功能变化。结果与手术前相比,D组患者的简易智力状态检查法（MMSE）测试评分无明显改变（P〉0.05）,而C组患者的MMSE测试评分显著降低（P〈0.05）,手术后第1天和第3天D组患者的MMSE测试评分显著优于C组（P〈0.05）,两组患者术后早期认知功能障碍的发生率分别为22.5%和55.0%,C组患者的术后早期认知功能障碍明显高于D组且障碍程度较重（P〈0.05）。结论右美托咪定有利于缓解直肠癌患者在进行腹腔镜下直肠癌根治术后的早期认知功能障碍,在临床上有一定的推广价值。

Effects of dexmedetomidine in patients undergoing radical laparoscopic proctectomy for rectal cancer on early cognitive dysfunction

ObjectiveTo evaluate the effects of dexmedetomidine in patients undergoing radical laparoscopic proctectomy for rectal cancer on early cognitive dysfunction.Methods80 patients of ASA grade I or II, scheduled for radical laparoscopic proctectomy, were randomly assigned into two groups： group D（n=40） and group C（n=40）. Group D and group C received through intravenous infusion dexmedetomidine and normal saline respectively, and early changes of cognitive function were observed in both groups of patients after operation.ResultsCompared with peroperation, mini-mental state examination method （MMSE） test score of patients in group D did not change significantly （P〉0.05）, while MMSE test scores in group C of patients were significantly lower （〈0.05）, after 1st and 3rd day, MMSE test scores in group D were significantly better than group C（P〈0.05）, the incidence of early postoperative cognitive dysfunction in two groups was 22.5 % and 55.0 % respectively, postoperative early cognitive dysfunction of patients in group C was more serious than it in group D （P〈0.05）.ConclusionIntravenous infusion dexmedetomidine helps alleviate early postoperative cognitive dysfunction of patients undergoing radical laparoscopic proctectomy for rectal cancer, which is worthy to be extended in clinical practice.