CAJ | 학술논문

目的：观察不同剂量右美托咪定对胃癌根治术患者血流动力学及应激反应的影响。方法：选择90例全麻下行胃癌根治术的患者，随机分为三组（ C、D1和D2组），每组30例。 C组为对照组，给予等量生理盐水；D1、D2组为右美组，于麻醉诱导前10min 内分别给予负荷剂量0．5μg/kg、0．8μg/kg，术中维持速度分别为0．5μg· kg-1· h-1、0．8μg· kg-1· h-1。记录三组病人：入室时（T0）、气管插管毕即刻（T1）、切皮时（T2）、进腹（T3）、手术开始后30min（T4）、术毕（T5）各时点心率（HR）、收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）、血浆皮质醇（Cor）和血糖（Glu）以及不良反应例数。结果：T1、T2、T3时点C组HR、SBP、DBP、MAP明显高于D1、D2组（ P＜0．05）；T5时点C组的Cor、Clu浓度高于D1、D2组（P＜0．05）。 C组各时点血流动力学波动明显（P＜0．05），而D1、D2组波动不大（P＞0．05）。不良反应例数D2组多于D1组。结论：中等剂量右美0．5μg/kg更适用于胃癌根治术患者临床应用。
목적：관찰불동제량우미탁미정대위암근치술환자혈류동역학급응격반응적영향。방법：선택90례전마하행위암근치술적환자，수궤분위삼조（ C、D1화D2조），매조30례。 C조위대조조，급여등량생리염수；D1、D2조위우미조，우마취유도전10min 내분별급여부하제량0．5μg/kg、0．8μg/kg，술중유지속도분별위0．5μg· kg-1· h-1、0．8μg· kg-1· h-1。기록삼조병인：입실시（T0）、기관삽관필즉각（T1）、절피시（T2）、진복（T3）、수술개시후30min（T4）、술필（T5）각시점심솔（HR）、수축압（SBP）、서장압（DBP）、평균동맥압（MAP）、혈장피질순（Cor）화혈당（Glu）이급불량반응례수。결과：T1、T2、T3시점C조HR、SBP、DBP、MAP명현고우D1、D2조（ P＜0．05）；T5시점C조적Cor、Clu농도고우D1、D2조（P＜0．05）。 C조각시점혈류동역학파동명현（P＜0．05），이D1、D2조파동불대（P＞0．05）。불량반응례수D2조다우D1조。결론：중등제량우미0．5μg/kg경괄용우위암근치술환자림상응용。
Objective:To observe the effects of different doses of dexmedetomidineon on hemodynamics and stress reflect in radical gastrectomy for gastric cancer .Method:90 patients underwent radical operation for gastric cancer were subjected .They were divided into three groups randomly , 30 cases in each group ( group C,D1 and D2) .Group C was offered the same amount of physiological saline .Two test groups ( D1 and D2 ) was given 0.5μg/kg and 0.8μg/kg loading dose of dexmedetomidine within 10min before endotrachael intubation,while 0.5μg· kg-1 · h-1 and 0.8μg· kg-1 · h-1 was pumped with micropump during the opera-tion.The parameters of heart rate (HR),systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure ( MAP ) were recorded in the following time :just entering operating room ( before Dex be given)(T0), immediately after intubation (T1), skin incision (T2), opening abdomen(T3),30min after the start of the operation (T4), end of the surgery(T5).At T5 time corticosteroid (Cor) and glucose ( Glu) of the arterial blood were measured .And recorded the adverse reactions .Result: Group C compared with group D1 and D2 of hemodynamic has obviously statistical differences at the time of T 1,T2,T3(P <0. 05), and Cor and Glu at T5 time, group C were higher than group D1 and D2 (P<0.05);The comparison of hemodynamic has obviously differences ( P<0.05) within group C in each time , but there were little changes between group D1 and D2 (P >0.05).The adverse reactions of group D2 were more than group D1.Conclu-sion:Middle dose of 0.5μg /kg dexmedetomidine is more suitable for the patients with gastric cancer .