右美托咪定联合瑞芬太尼对结肠癌患者术后认知功能及血流动力学的影响

发布时间：2018-04-03 16:52

本文选题：右美托咪定　切入点：瑞芬太尼　出处：《中国药房》2017年08期

【摘要】：目的:探讨右美托咪定联合瑞芬太尼对结肠癌患者术后认知功能和血流动力学的影响及安全性。方法:选取我院2013年6月-2016年4月拟行结肠癌术患者100例,按随机数字表法分为对照组和观察组,各50例。对照组患者给予注射用盐酸瑞芬太尼2~4μg/kg麻醉诱导,维持剂量为0.5~2μg·kg/min;观察组患者给予盐酸右美托咪定注射液0.5μg/kg+瑞芬太尼2~4μg/kg麻醉诱导,维持剂量为盐酸右美托咪定注射液0.4μg·kg/h+注射用盐酸瑞芬太尼0.5~2μg·kg/min。观察两组患者术后1、2、3 d的简易智力状态检查量表(MMSE)评分及认知功能障碍(POCD)发生率,并记录不良反应发生情况。结果:观察组患者术后1、2、3 d POCD发生率分别为16.0%、4.0%、6.0%,显著低于对照组的36.0%、12.0%、10.0%,差异均有统计学意义(P0.05)。两组患者术后1、3 d MMSE评分比较,差异无统计学意义(P0.05);术后2 d,观察组患者MMSE评分显著高于对照组,差异有统计学意义(P0.05)。两组患者术后1、2、3 d的血流动力学指标及血压增高、肌颤、恶心呕吐等不良反应发生率比较,差异均无统计学意义(P0.05)。结论:右美托咪定联合瑞芬太尼对结肠癌患者术后POCD具有明显的改善作用,对患者术后的血流动力学影响较小,安全性较好。
[Abstract]:Objective: to investigate the effect and safety of dexmetomidine combined with remifentanil on cognitive function and hemodynamics in patients with colon cancer after operation.Methods: 100 patients with colon cancer from June 2013 to April 2016 were randomly divided into control group and observation group with 50 cases each.The patients in the control group were anesthetized with remifentanil hydrochloride (2 渭 g/kg) for injection at a maintenance dose of 0.5 渭 g / min, and those in the observation group were anesthetized with remifentanil hydrochloride (0.5 渭 g/kg) and remifentanil (4 渭 g/kg).Remifentanil hydrochloride 0.5 渭 g 路kg ~ (-1) 路min for dexmetomidine hydrochloride injection 0.4 渭 g / kg/h.The MMSE score and the incidence of cognitive dysfunction (POCD) were measured on the 1st and 2nd day after operation in the two groups, and the adverse reactions were recorded.Results: in the observation group, the incidence of POCD was 16.0 and 4.0 on the 3rd day after operation, which was significantly lower than that in the control group (36.0 / 12.0 / 10.0), and the difference was statistically significant (P 0.05).There was no significant difference in MMSE score between the two groups on the 1st and 3rd day after operation, but on the 2nd day after operation, the MMSE score in the observation group was significantly higher than that in the control group (P 0.05).There was no significant difference in the incidence of hemodynamic indexes, blood pressure, muscle fibrillation, nausea and vomiting between the two groups on the 3rd day after operation (P 0.05).Conclusion: dexmetomidine combined with remifentanil can significantly improve postoperative POCD in patients with colon cancer.
【作者单位】：四川省人民医院城东病区麻醉科;
【分类号】：R614;R735.35

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