目的：探讨负荷剂量右美托咪定(dexmedetomidine，DEX)的使用对结直肠切除术后肠功能恢复的影响。方法：回顾性分析我院2017年10月到2018年8月收治的196例行腹腔镜结直肠切除术患者的临床资料，根据术中是否输注负荷剂量（1ug/kg）DEX分为两组。实验组（负荷剂量：DEX 1ug/kg，输注10min；维持剂量：0.4 ug/kg/h）87例；对照组（维持剂量：0.4 ug/kg/h输注）109例。患者术后首次排气时间为主要观察指标，首次排便时间、术后恶心呕吐发生率及住院时间为次要观察指标。比较两组患者术后排气排便时间；恶心、呕吐发生率以及住院时间。明确输注负荷剂量DEX对术后肠功能恢复的影响。结果：实验组术后3天内排气患者比例高于对照组（71.26% vs 60.55%），术后排气时间较对照组缩短（2.95±1.01 vs 3.51±1.25，P=0.002），两组患者术后恶心呕吐发生率及住院时间无明显差异。结论：腹腔镜结直肠切除术中使用负荷剂量DEX可以促进患者肠功能的早期恢复，缩短患者术后排气时间。
Objective To investigate the effect of loading dose dexmedetomidine（DEX） on intestinal function recovery after colorectal resection. Methods The clinical data of 196 patients with laparoscopic colorectal resection admitted to our hospital from October 2017 to August 2018 were retrospectively analyzed. They were divided into two groups according to whether the load dose (1ug/kg) DEX was pumped during the operation. The experimental group (loading dose: 1ug/kg, infusion10min; maintenance dose:0.4ug/kg/h) 87cases; Control group (maintenance dose: 0.4ug/kg/h pump injection) 109 cases. The time to first flatus was the main observation index, while the time to first defecation, incidence of postoperative nausea and vomiting and hospitalization time were secondary observation indexes. The time of flatus and defecation, the incidence of nausea and vomiting and the length of hospital stay were compared between the two groups. To determine the effect of DEX loading dose infusion on postoperative intestinal function recovery. Results The flatus rate of patients in the experimental group within 3 days after operation was higher than that in the control group (71.26%vs60.55%), and the flatus time after operation was shorter than that in the control group (2.95 1.01 vs 3.51 1.25, P=0.002). There was no significant difference in the incidence of postoperative nausea and vomiting and hospitalization time between the two groups. Conclusion: Intestinal inflammation is one of the important factors that delay the recovery of intestinal function after operation. DEX loading dose infusion ensures higher blood drug concentration and reduce intestinal inflammation, which plays a positive role in inflammation inhibition and benefits the early recovery of intestinal function
Cited
)
