摘要
Abstract
Objective To investigate clinical value of dexmedetomidine in elderly patients with laparoscop?ic radical gastrectomy for gastric cancer. Methods One hundred eldly gastric cancer patients were randomly divided into two groups: observation group and control group. Before induction, observation group accepted infu?sion of Dexmedetomidine (1 μg/kg, in 10 min), whereas the control group accepted saline infusion. Both groups received intraoperative intravenous infusion of propofol and remifentanil and intermittent bolus injection of cis-atracurium to maintain the depth of anesthesia. The observation group was given dexmedetomidine infusion at 0.5 μg·kg-1·h-1, whereas the control group accepted infusion of normal saline. Arterial pressure (MAP) and heart rate (HR) level were recorded at different time in two groups, and blood samples were taken for determination of Troponin T (cTnI), heart fatty acid binding protein (H-FABP) and creatine kinase isoenzyme (CK-MB) by ELI?SA. The mini mental state examination (MMSE) scores were compared to assess postoperative cognitive dysfunc?tion. Results MAP and HR levels in the observation group were lower than those in control group at 5 min af?ter intubation and 1 h after cutting skin (all P<0.05). Levels of cTnI in observation group at cutting skin, 1 h after operation and the end of operation were (0.49 ± 0.06) ng/mL, (0.92 ± 0.05) ng/mlL and (1.24 ± 0.09) ng/mL, respectively. But for levels of H-FABP, they were (0.45±0.09) μg/mL, (0.48±0.06) μg/mL and (0.59 ±0.09) μg/mL at the three time points. All these values in observation group were lower than those in control group. The level of CK-MB in observation group was (25.47 ± 3.86) U/mL at the end of operation. It was lower than that in control group (29.52 ± 3.57) U/mL (P<0.05). Observation group's MMSE score at 1 d and 7 d after operation were (24.5 ± 1.9) and (25.3 ± 2.1), higher than those in control group [(21.3 ± 1.8), (23.6 ± 2.0), (P<0.05)]. Conclusion Dexmedetomidine used in laparoscopic surgery for gastric cancer radical operation can stabilize he?modynamics and decrease cTnI、H-FABP and CK-MB levels. It has protective effect on myocardium and postoperative cognitive dysfunction.关键词
右美托咪啶/胃癌根治术/老年/心肌保护/认知功能障碍Key words
Dexmedetomidine/radical gastrectomy/elderly patients/myocardial protection/cognitive dys⁃function分类
医药卫生
