右美托咪定对腹腔镜结直肠癌根治术患者术后转归的影响

目的 探讨盐酸右美托咪定注射液对腹腔镜结直肠癌根治术患者术后转归的影响。方法 选取2015年6月-2017年6月眉山市人民医院行腹腔镜结直肠癌根治术患者160例作为研究对象，按随机数字表法将患者分为对照组和观察组，每组各80例。两组患者均采用全身麻醉，观察组在此基础上于麻醉诱导前10 min采用微量注射泵静脉输注盐酸右美托咪定注射液0.5 μg/（kg·h），10 min内泵完，再以0.5 μg/（kg·h）维持至手术结束。对照组按照相同的输注方式给予相同剂量的生理盐水。比较两组术后复苏指标、不同时间点血流动力学指标、镇痛及镇静效果分数。结果 术后两组患者睁眼时间、呼吸恢复时间、拔管时间差异无统计学意义；观察组躁动评分显著低于对照组（P<0.05）。治疗后，T₀-T₃时刻两组患者平均动脉压（MAP）、心率（HR）水平先降低再升高最终又降低，且T₁、T₂时刻观察组明显低于对照组（P<0.05）。术后观察组患者Ramsay镇静评分、静息及咳嗽VAS评分均明显降低于对照组（P<0.05）。结论 盐酸右美托咪定注射液可显著减少腹腔镜结直肠癌根治术的应激反应，改善血流动力学，镇静镇痛效果显著，减少复苏期躁动的发生，且未增加不良反应，有利于患者术后转归。

Effect of dexmedetomidine on postoperative outcomes in patients undergoing laparoscopic radical resection of colorectal cancer

Objective To investigate the effect of Dexmedetomidine Hydrochloride Injection on postoperative outcomes in patients undergoing laparoscopic radical resection of colorectal cancer.Methods Patients (160 cases) with laparoscopic radical resection of colorectal cancer in Meishan People''s Hospital from June 2015 to June 2017 were divided into control and observation groups according to the random number table method, each group had 80 cases. Patients in two groups were given general anesthesia. Observation group received intravenous infusion of Dexmedetomidine Hydrochloride Injection 0.5 ug/(kg·h) with a microinjection pump in 10 min before induction of anesthesia, then maintained at 0.5 ug/(kg·h) until the end of operation. The control group was given the same dose of saline by the same infusion method. The various indexes of anabiosis, the indexes of haemodynamics at different time points, and the analgesia and sedation scores were compared in two groups. Results There was no statistically significant difference between the two groups in the time of eye opening, respiratory recovery and extubation, the restlessness score in the observation group was significantly lower than that in the control group (P<0.05). After treatment, the MAP and HR levels in two groups from T₀ to T₃ were decreased, and then increased, and decreased finally, and at T₁ and T₂, the observation group was significantly lower than those in the control group (P<0.05). The Ramsay sedation score, resting and cough VAS scores in the observation group were significantly lower than those in the control group (P<0.05).Conclusions Dexmedetomidine Hydrochloride Injection can significantly reduce the stress response, improve hemodynamics, sedative and analgesic effect is remarkable, and reduce the occurrence of restlessness in the recovery period without increasing adverse reactions, which is conducive to the postoperative outcome of patients.