目的 研究右美托咪定对腹腔镜卵巢囊肿切除术患者应激反应的影响.方法 30例择期全麻下行腹腔镜卵巢囊肿切除术患者随机分为两组:右美托咪定组(A组):麻醉诱导时静脉输注右美托咪定1μg/kg,并以静脉输注右美托咪定0.5μg/(kg·h)维持；对照组(B组)不用右美托咪定.观察麻醉前、麻醉诱导后插管前、插管后5 min、肿瘤切除时和术毕时的MAP,HR和BIS值.同时抽取静脉血供检测去甲肾上腺素和心钠素用.结果 与T0比较,两组患者去甲肾上腺(NA)在T1、T2、T3及T4增高(P＜0.05),A组患者增高显著低于B组(P＜0.05).与T0比较,两组T1时点心钠素(ANP)差异无显著性(P＞0.05),T2、T3、T4时点ANP均增高(P＜0.05),但B组显著高于A组(P＜0.05).结论 腹腔镜卵巢囊肿切除术患者术中使用右美托咪定可显著减轻患者的应激反应,有利于内环境稳定.%[Objective] To investigate effects of dexmedetomidine on atrial natriuretic peptide and norepinephrine in patients with ovarian cystectomy. [Methods] 30 patients underwent elective laparoscopic ovarian cystectomy with general anesthesia were randomly divided into two groups: Dexmedetomidine group (Group A): intravenous infusion of dexmedetomidine given 1μg/kg during induction of anesthesia, and 0.5μg/(kg·h) maintained during operation. Control group (Group B) without dexmedetomidine given. MAP, HR, and BIS values were recorded and venous blood was assayed for norepinephrine and atrial natriuretic peptide at induction of anesthesia, intubation after induction of anesthesia, 5 min after intubation and tumor removal. [Results] Norepinephrine at T1, T2 T3 T4 in two groups of patients increased significantly (P ＜0.05) compared with that in TO and Group A of patients increased significantly lower than group B (P ＜0.05). Compared with TO, there were no differences ANP of the two groups at Tl (P ＞0.05), ANP was significantly higher at T2, T3 T4 in two groups (P ＜0.05), but group B was significantly higher than group A (P ＜0.05). [Conclusions] Laparoscopic ovarian cystectomy of patients with intraoperative use of dexmedetomidine would reduce the patient's stress response and conducive to homeostasis.
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