中国健康心理学杂志2019，Vol.27Issue(3)：373-376,4.DOI:10.13342/j.cnki.cjhp.2019.03.015
右美托咪定复合乌司他丁对老年结直肠癌根治术患者术后谵妄的影响
Effect of dexmedetomidine combined with ulinastatin on postoperative delirium in elderly patients with colorectal cancer
摘要
Abstract
Objective:To investigate the effect of dexmedetomidine combined with ulinastatin on postoperative delirium in elderly patients with colorectal cancer.Methods:From February 2014to February 2016, a total of 120patients undergoing colorectal cancer radical surgery in our hospital were treated as subjects.The selected patients were divided into control and observation groups according to the drugs used for anesthesia.Patients in the control group were given an ulinastatin 10, 000mg/kg intravenously before anesthesia induction, and intravenously completed in 15～20minutes.The observation group was given intravenous infusion of ulinastatin at 10, 000U/kg before anesthesia induction, intravenous injection was performed in 15～20minutes, and then 0.5μg/kg dexepamidine was administered intravenously at a dose of 0.3μg/ (kg·h) .Wo compared the surgical indicators, serum catecholamine concentration, serum inflammation, delirium and adverse drug reactions of the two groups of patients.Results: (1) There were no significant differences between the two groups in operation time, intraoperative blood loss, infusion volume and anesthesia awake time. (2) The levels of IL-6, S100βand IL-10in the two groups were significantly higher than those before anesthesia at the end of the operation and the third day after the operation (F=3972.70, 1309.30, 676.87, 498.45, 3935.56, 735.61;P＜0.001) .The level of IL-6and S100βin the observation group were significantly lower than those in the control group (t=-37.896, -33.084, -20.320, -6.789;P＜0.001) ; (3) The level of catecholamine in the control group at the end of the operation and the third day after the operation were significantly higher than that before the anesthesia (F=101.19, 311.24, 182.07;P＜0.001) .At the end of the operation, the level of catecholamines was higher than that before anesthesia and returned to the anesthesia on the third day after surgery (F=3.62, 65.08, 9.36;P＜0.05) , the level of catecholam was significantly lower in the observation group than that in the control group at the end of the operation and the third day after operation (t=10.868, 11.134, 12.245, 17.456, 13.292, 9.184;P＜0.001) ; (4) The incidence of delirium in the observation group was significantly lower than that in the control group (χ2=4.615, P＜0.05) . (5) There were 8cases (13.33％) of adverse drug reactions in the observation group and 5cases (8.33％) in the control group, there was no significant difference between the two groups.Conclusion:Umevitidine in combination with ulinastatin can clearly inhibit the release of inflammatory factors and catecholamines in colorectal cancer patients, reduce the incidence of delirium, and the combination of these two drugs has no serious adverse reactions, which is worthy of clinical promotion.关键词
右美托咪定/乌司他丁/结直肠癌根治术/谵妄Key words
Dexmedetomidine/Ulinastatin/Colorectal cancer radical surgery/Delirium分类
医药卫生引用本文复制引用
刘旭江,许舒娅,朱亚妮,王媛媛..右美托咪定复合乌司他丁对老年结直肠癌根治术患者术后谵妄的影响[J].中国健康心理学杂志,2019,27(3):373-376,4.基金项目
湖北省自然科学基金(编号:2015CBD0319) （编号:2015CBD0319）
