摘要
目的:探讨右美托咪定复合全身麻醉在老年低位直肠癌腹腔镜微创直肠全系膜切除术中的应用效果。方法:选取2015年12月至2017年9月陕西省安康市中心医院收治的老年低位直肠癌患者74例,按随机数字表法分为研究组和对照组,每组37例。对照组采取全身麻醉,研究组采取右美托咪定复合全身麻醉。比较两组麻醉药物用量、不良反应发生率、不同时间段血清应激反应指标皮质醇(Cor)、T细胞亚群指标、NK细胞水平。结果:与对照组比较,研究组麻醉药物用量减少,T1期、T2期血清Cor、CD8+水平降低,血清CD3+、CD4+、NK细胞水平及CD4+/CD8+升高,不良反应发生率降低,差异均有统计学意义(均P<0.05)。结论:老年低位直肠癌患者腹腔镜微创直肠全系膜切除术中采取右美托咪定复合全身麻醉,可减少麻醉药物用量,减轻术后机体免疫抑制及应激反应,且安全性好。
Objective:To investigate the effect of dexmedetomidine combined with general anesthesia application in elderly patients with low rectal cancer undergoing laparoscopic minimally invasive surgery of total mesorectal excision.Methods:A total of 74 elderly patients with low rectal cancer in our hospital from December 2015 to September 2017 were selected,and randomly assigned to receive either general anesthesia(control group,n=37)or dexmedetomidine combined with general anesthesia(study group,n=37).The anaesthetic drugs dosage,the incidence of adverse reactions,the serum cortisol(Cor)level,and CD3+,CD4+,CD8+and NK cells levels were compared.Results:The dosage of anaesthetic drug and the serum levels of Cor and CD8+in T1 and T2 stages in the study group were lower than those in the control group,while the serum levels of CD3+,CD4+and NK cells as well as the CD4+/CD8+ratio were significantly higher(P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group(P<0.05).Conclusion:Dexmedetomidine combined with general anesthesia was safe in elderly patients with low rectal cancer undergoing laparoscopic minimally invasive surgery of total mesorectal excision.It could reduce the amount of anaesthetic drugs,and attenuate the inhibition of immune function and stress response.
引文
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