摘要
目的探讨右美托咪定联合七氟烷对食管癌根治术患者应激指标、脑氧代谢指标、认知功能及高迁移率族蛋白B1(high mobility group protein B1,HMGB1)水平的影响。方法选取2020年1月至2022年12月周口市中心医院收治的124例食管癌患者,随机分为对照组及观察组各62例。观察组麻醉诱导前给予右美托咪定,对照组麻醉诱导后给予生理盐水,两组采用相同的麻醉诱导及麻醉维持方案。比较两组患者应激反应指标、脑氧代谢指标、术后认知功能障碍发生情况及外周血HMGB1含量。结果在T_(0)时两组皮质醇(Cor)、丙二醛(MDA)水平、脑氧摄取率(CERO_(2))及动脉—颈内静脉血氧含量差(Da-jvO_(2))无显著差异(P>0.05);T_(1)及T_(2)时观察组患者Cor及MDA水平、CERO_(2)及Da-jvO_(2)水平均显著低于对照组患者(P<0.05)。观察组术后认知功能障碍发生率(6.45%)与对照组(22.58%)相比显著降低(P<0.05)。观察组术后1 d及3 d外周血HMGB_(1)水平显著下降(P<0.05)。结论麻醉诱导前输注右美托咪定应用于食管癌根治术可缓解患者应激反应、调节脑氧代谢并降低术后认知功能障碍的发生率。
Objective To study the effects of dexmedetomidine and sevoflurane on stress indexes,cerebral oxygen metabolism indexes,cognitive function,and HMGB1 content in patients undergoing radical resection of esophageal cancer.Methods 124 patients with esophageal cancer admitted to our hospital from January 2020 to December 2022 were randomly divided into a control group and an observation group,with 62 cases in each.The observation group was given dexmedetomidine before anesthesia induction,while the control group was given saline.The two groups used the same anesthesia induction and maintenance plan.The stress response indicators,brain oxygen metabolism indicators,postoperative cognitive impairment,and peripheral blood HMGB 1 levels were compared between two groups.Results At T_(0),there was no significant difference in cortisol(Cor),malondialdehyde(MDA)levels,cerebral oxygen uptake rate(CERO_(2)),and arterial jugular vein oxygen content difference(Da-jvO2)between the two groups(P>0.05).At T1 and T2,the levels of Cor and MDA,CERO_(2),and Da jvO_(2) in the observation group were significantly lower than those in the control group(P<0.05).The incidence of postoperative cognitive impairment in the observation group(6.45%)was significantly reduced compared to the control group(22.58%)(P<0.05).The observation group showed a significant decrease in peripheral blood HMGB_(1) levels on the 1st and 3rd day after surgery(P<0.05).Conclusion Dexmedetomidine before anesthesia induction could relieve stress response,regulate cerebral oxygen metabolism,and reduce the incidence of postoperative cognitive dysfunction in patients undergoing radical resection of esophageal cancer.
作者
陈龙
CHEN Long(Anesthesia Department of Zhoukou Central Hospital,Zhoukou,China,466000)
出处
《食管疾病》
2024年第1期44-48,75,共6页
Journal of Esophageal Diseases
