右美托咪定联合舒芬太尼对腹腔镜胃癌切除患者术后镇痛作用、早期认知功能及对血清炎症因子水平影响研究

摘要

Objective To explore the effect of dexmedetomidine combined with sufentanil on postoperative analgesia , early postoperative cognitive function and serum inflammatory factors in patients with laparoscopic gastrectomy of gastric cancer.Methods 80 cases of laparoscopic resection of gastric cancer were randomly assigned to treatment group and control group.The control group were treated by sufentanil 1.6μg/kg.The treatment group were given sufentanil 1.6μg/kg combined with dexmedetomidine 2 μg/kg.The analgesic effect, early cognitive function and serum levels of inflammatory factors were tested and compared after surgery.Results Compared with the control group, the VAS score in 4 h,8 h,24 h and 48 h after surgery were lower in the treatment group (P<0.05), the POCD(P<0.05), the IL-6,IL-10 and TNF-αlevel were lower in the treatment group(P<0.05). Conclusion Dexmedetomidine combined with sufentanil showes better postoperative analgesic effect and fast recovery of cognitive function, regulate the levels of serum inflammatory cytokines after laparoscopic resection of gastric cancer .%目的：探究右美托咪定联合舒芬太尼对腹腔镜胃癌切除患者术后镇痛作用、早期认知功能及对血清炎症因子水平影响。方法收集行腹腔镜胃癌切除术治疗患者80例，随机分为对照组和治疗组，对照组术后给予舒芬太尼1．6μg／kg，治疗组在对照组基础上给予右美托咪定2μg／kg。比较2组患者术后镇痛作用、早期认知功能及对血清炎症因子水平。结果治疗后与对照组相比，治疗组术后4 h、8 h、24 h以及48 h疼痛视觉模拟评分（visual analogue scale，VAS）评分较低（P＜0．05）；与对照组相比，治疗组术后术后认知功能障碍（postoperative cognitive dysfunction，POCD）发生率明显较低（P＜0．05）；且患者白介素－6（interleukin－6，IL－6）、白介素－10（interleukin－10，IL－10）及肿瘤坏死因子－α（tumor necrosis factor－α，TNF－α）水平较低（P＜0．05）。结论右美托咪定联合舒芬太尼对腹腔镜胃癌切除术后镇痛作用明显，快速恢复早期认知功能，调节血清炎症因子水平。