右美托咪啶对乳腺癌根治术术后患者自主神经平衡及认知功能的影响分析

Effect of dexmedetomidine on autonomic nervous balance and cognitive function in patients after radical mastectomy

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DOI
刊名
Journal of International Psychiatry
年,卷(期) 2019, 46(6)
作者
作者单位

.鹤壁煤业(集团)有限责任公司总医院普外科 ;

摘要
分析乳腺癌行根治术治疗患者应用右美托咪啶治疗后的效果及认知功能变化。方法 采用随机数字表法将我院115例欲行乳腺癌根治术治疗的患者分组,两组患者麻醉方法相同,对照组57例于麻醉诱导前给予生理盐水静脉泵入,观察组58例于麻醉诱导前给予右美托咪啶静脉泵入,对比两组患者治疗后血清皮质醇(Cor)、多巴胺(DA)、去甲肾上腺素(NE)、血流动力学指标、自主神经平衡、认知功能及术后不良事件发生率。结果 术后1h,观察组 HF、LF/HF水平均低于对照组;术后6h,观察组 DA、NE、Cor、HR、SP水平低于对照组,MAP水平高于对照组;术后24h,观察组 DA、NE、Cor、HR水平低于对照组,MAP水平高于对照组,术后72h,观察组 NE水平低于对照组;观察组术后24、72h、7d MMSE评分高于对照组,不良事件发生率低于对照组(P<0.05)。结论 右美托咪啶能够有效抑制中枢交感神经活性,维持自主神经平衡,减轻血流动力学波动及应激反应,促进乳腺癌根治术患者认知功能恢复,减少不良事件发生率。
Abstract
Objective To analyze the effect and cognitive function of patients undergoing radical mastectomy for breast cancer after treatment with dexmedetomidine. Methods A total of 115 patients who underwent radical mastectomy were enrolled in this study. The anesthesia method was the same in the two groups. 57 patients in the control group were given intravenous saline before anesthesia induction, and 58 patients in the observation group were anesthetized. Intravenous infusion of dexmedetomidine before induction, comparing serum cortisol (Cor), dopamine (DA), norepinephrine (NE), hemodynamics, autonomic balance, cognition after treatment Function and incidence of postoperative adverse events. Results At 1 h after operation, the levels of HF and LF/HF in the observation group were lower than those in the control group. At 6 h after operation, the levels of DA, NE, Cor, HR and SP in the observation group were lower than those in the control group, and the MAP level was higher than that in the control group. The levels of DA, NE, Cor and HR in the observation group were lower than those in the control group, and the MAP level was higher than that in the control group. At 72 hours after operation, the NE level in the observation group was lower than that in the control group; the MMSE score in the observation group was higher than that in the control at 24, 72, and 7 days after operation. The incidence of adverse events was lower in the group than in the control group (P<0.05). Conclusion Dexmedetomidine can effectively inhibit central sympathetic nerve activity, maintain autonomic balance, reduce hemodynamic fluctuations and stress response, promote cognitive function recovery in patients undergoing radical mastectomy, and reduce the incidence of adverse events.
关键词
右美托咪啶;乳腺癌根治术;自主神经平衡;认知功能;血流动力学
KeyWord
dexmedetomidine; radical mastectomy; autonomic balance; cognitive function; hemodynamics
基金项目
页码 1105-1107
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赵鸿*. 右美托咪啶对乳腺癌根治术术后患者自主神经平衡及认知功能的影响分析 [J]. 国际精神病学杂志. 2019; 46; (6). 1105 - 1107.

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