右美托咪定对腹腔镜下阑尾切除术患者肝肾功能及应激反应的影响.docVIP

右美托咪定对腹腔镜下阑尾切除术患者肝肾功能及应激反应的影响 　　[摘要] 目的 研究分析右美托咪定对腹腔镜下阑尾切除术患者肝肾功能及应激反应的影响。 方法 以解放军第九四医院收治的128例行腹腔镜阑尾切除术的患者为研究对象，随机分成联合组和单用组，各64例。联合组采用右美托咪定加丙泊酚进行麻醉诱导和维持，而单用组采用丙泊酚进行麻醉诱导和维持。对麻醉前、插管后1 min、术后5 min的血清皮质醇和儿茶酚胺水平进行测定，同时测定术前及术后的肝肾功能。 结果 单用组丙泊酚诱导剂量以及维持剂量均明显高于联合组，差异有统计学意义（P 0.05）；两组患者插管后1 min血清皮质醇、肾上腺素、去甲肾上腺素水平均较麻醉前明显降低（P 0.05），术后5 min单用组患者肾上腺素、去甲肾上腺素水平较麻醉前均明显升高（P 0.05）；两组患者术后5 min血清多巴胺水平均较麻醉前明显上升（P 0.05）；两组患者术后尿素氮水平较麻醉前明显降低，血糖较麻醉前明显升高（P 0.05）。 结论 右美托咪定联合小剂量丙泊酚可以有效减少气管插管时的应激反应，并使丙泊酚的使用剂量减少，对肝肾功能无明显影响，值得在临床实践中加以推广应用。 　　[关键词] 右美托咪定；腹腔镜；肝肾功能；应激 　　[中图分类号] R614.2 [文献标识码] A [文章编号] 1673-7210（2013）11（a）-0097-04 　　Influence of Dexmedetomidine on stress reaction and hepatic/renal function in the process of laparoscopic abdominal surgery 　　MENG Haibing1 LAI Wei1 WANG Xinlei1 DING Guoyou1▲ ZHANG Xiaoguang2 　　1.Department of Anesthesiology， the 94th Hospital of Peoples Liberation Army， Jiangxi Province， Nanchang 330002， China； 2.Department of Anesthesiology， Zhongshan Hospital Affiliated to Fudan University， Shanghai 200032， China 　　[Abstract] Objective To investigate the influence of Dexmedetomidine on stress reaction and hepatic/renal function in the process of laparoscopic appendectomy. Methods 128 patients scheduled for laparoscopic appendectomy admitted to the 94th Hospital of Peoples Liberation Army were randomly divided into the combined group and the single-drug group， each with 64 patients. The combined group was given Dexmedetomidine and Propofol， while the single-drug group was given Propofol for induction and maintenance of anesthetics. Venous blood samples were collected before anesthetics， 1 min after intubation and 5 min after surgery for the determination of plasma concentrations of cortisol， dopamine， epinephrine and norepinephrine. Hepatic/renal function was assessed before and after surgery. Results The dose of induction and maintenance in the single-drug group was significantly higher than that in the combined group （P 　　[Key words] Dexmedetomidine； L