右美托咪定與依托咪酯對(duì)胃癌全麻根治術(shù)后鎮(zhèn)痛的療效及其對(duì)感染和血流動(dòng)力學(xué)影響

李赟赟

[關(guān)鍵詞] 右美托咪定;依托咪酯;胃癌;血流動(dòng)力學(xué);鎮(zhèn)痛

[中圖分類號(hào)] R735.2? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] B? ? ? ? ? [文章編號(hào)] 1673-9701（2021）19-0136-04

The effect of dexmedetomidine and etomidate on postoperative analgesia after general anesthesia radical surgery for gastric cancer and its influence on infection and hemodynamics

LI Yunyun

Department of Anesthesiology， Qinghai Traffic Hospital， Xi′ning? ?810000， China

[Abstract] Objective To investigate the effect of dexmedetomidine and etomidate on the postoperative analgesia after general anesthesia radical surgery for gastric cancer and its influence on infection and hemodynamics. Methods In this paper， 139 patients admitted to our hospital from July 2016 to July 2020 were randomly divided into the observation group （n=70） and the control group （n=69）. The control group was given etomidate to induce anesthesia. The observation group was anesthetized with dexmedetomidine. The pain score， infection， and hemodynamic changes between the two groups were observed and compared. Results After anesthesia， the pain scores of the two groups decreased significantly （t=11.259， P=0.000; t=8.524， P=0.000）. The pain scores of the observation group were significantly lower than those of the control group （t=11.690， P=0.000）. The incidence of infection in the observation group was 5.71%， which was significantly lower than the 17.39% in the control group （χ2=4.652， P=0.031）. During medication and extubation， the heart rate of the control group was lower than that of the observation group （P<0.05）. There was no significant difference in systolic and diastolic blood pressure （P>0.05）. Conclusion Dexmedetomidine and etomidate have a good effect on postoperative analgesia after general anesthesia radical surgery for gastric cancer， which can effectively reduce pain， maintain hemodynamic stability， and reduce the incidence of infection.

[Key words] Dexmedetomidine; Etomidate; Gastric cancer; Hemodynamics; Analgesia

胃癌是臨床常見的消化道惡性腫瘤，胃癌根治術(shù)是臨床治療胃癌的常用術(shù)式，全身麻醉則為手術(shù)治療提供重要基礎(chǔ)保障[1]。研究認(rèn)為，良好的麻醉效果可有效維持患者術(shù)中生命體征穩(wěn)定，減少內(nèi)環(huán)境紊亂所造成的機(jī)體應(yīng)激反應(yīng)，降低術(shù)后感染發(fā)生概率[2]。在臨床常用麻醉藥物中，右美托咪定屬于新一代α2-腎上腺素受體激動(dòng)劑，可有效抑制去甲腎上腺素釋放，終止疼痛信號(hào)傳導(dǎo);同時(shí)抑制交感神經(jīng)活性，達(dá)到鎮(zhèn)痛效果[3]。依托咪酯屬于非巴比妥類靜脈鎮(zhèn)靜藥物，是手術(shù)全身麻醉誘導(dǎo)的常用藥物[4]。我院于2016年7月～2020年7月共收治胃癌患者139例，所有患者均給予全麻醉根治術(shù)治療，并采用右美托咪定與依托咪酯進(jìn)行復(fù)合麻醉，旨在為此類患者的臨床麻醉治療提供科學(xué)理論依據(jù)，現(xiàn)報(bào)道如下。

1 資料與方法

1.1 一般資料

選自2016年7月至2020年7月于我院就診的胃癌全麻醉根治術(shù)患者139例，采用隨機(jī)數(shù)字法按1：1比例隨機(jī)分為觀察組（n=70）與對(duì)照組（n=69）。觀察組，男39例，女31例;年齡36～73歲，平均（57.25±4.48）歲;麻醉時(shí)間81～96 min，平均（92.37±2.62）min;手術(shù)時(shí)間59～86 min，平均（74.19±5.22）min;美國麻醉醫(yī)師學(xué)會(huì)（American society of anesthesiologists，ASA）分級(jí)：Ⅰ級(jí)47例，Ⅱ級(jí)23例。對(duì)照組，男42例，女27例;年齡38～75歲，平均（57.69±4.54）歲;麻醉時(shí)間80～102 min，平均（92.45±2.79）min;手術(shù)時(shí)間60～84 min，平均（74.08±5.15）min;ASA分級(jí)：Ⅰ級(jí)48例，Ⅱ級(jí)21例。兩組患者性別、年齡、麻醉時(shí)間、手術(shù)時(shí)間和ASA分級(jí)比較，差異無統(tǒng)計(jì)學(xué)意義，具有可比性（P>0.05）。