西南医科大学学报2025，Vol.48Issue(5)：524-528,5.DOI:10.3969/j.issn.2096-3351.2025.05.014
右美托咪定联合艾司氯胺酮对老年胃癌根治术后认知功能及炎症反应影响的随机对照试验
A Randomized Controlled Trial on the Effects of Dexmedetomidine Combined with Esketamine on Cognitive Function and Inflammatory Response After Radical Gastrectomy for Gastric Cancer in Elderly Patients
摘要
Abstract
Objective This study aimed to investigate the effects of dexmedetomidine combined with esketamine on postopera-tive cognitive function and inflammatory response in elderly patients undergoing radical gastrectomy.Methods A total of 150 elderly patients who underwent elective radical gastrectomy in our hospital between January 2021 and December 2023 were enrolled and ran-domly assigned to either the study group(dexmedetomidine combined with esketamine anesthesia,n=75)or the control group(dex-medetomidine anesthesia alone,n=75).Hemodynamic stability(heart rate and blood pressure),bispectral index(BIS)values,visual analogue scale(VAS)pain scores,incidence of postoperative cognitive dysfunction(POCD),postoperative recovery quality(QoR-40),sedation level(Ramsay score),and serum inflammatory markers(IL-6,TNF-α,CRP)were assessed and compared between groups using SPSS 26.0.Results The study group exhibited significantly lower intraoperative average heart rate,blood pres-sure fluctuations,and BIS values than the control group(P<0.05),and the incidence of POCD on postoperative days 1,3,7,and 30 was significantly reduced than the control group(P<0.05).Furthermore,the study group demonstrated significantly lower VAS pain scores and higher Ramsay sedation and quality of rccovery-40(QoR-40)recovery scores postoperatively(P<0.05).On postoperative days 3 and 14,serum levels of interleukin-6,tumor necrosis factor-α,and C-reactive protein were markedly lower in the study group than in the control group(P<0.05).Conclusion The combination of dexmedetomidine and esketamine in elderly patients undergoing radical gastrectomy not only helps to maintain stable intraoperative hemodynamics and anesthesia depth,reduce postoperative pain,improve sedation status and recovery quality,but also alleviates postoperative inflammatory response and improves cognitive function.These findings suggest that this combination therapy has clinical applicability and value for broader use.关键词
右美托咪定/艾司氯胺酮/老年患者/胃癌根治术/随机对照试验Key words
Dexmedetomidine/Esketamine/Elderly Patients/Radical Gastrectomy/Randomized Controlled Trial分类
医药卫生引用本文复制引用
张青,王亦瑶,梁楠,张天雪,周威..右美托咪定联合艾司氯胺酮对老年胃癌根治术后认知功能及炎症反应影响的随机对照试验[J].西南医科大学学报,2025,48(5):524-528,5.基金项目
河南省医学科技攻关计划项目(LHGJ20240782) （LHGJ20240782）
