2025 年第 3 期 第 20 卷

右美托咪定对腹腔镜结直肠癌手术患者围手术期神经认知紊乱及炎性介质的影响

Effects of dexmedetomidine on perioperative neurocognitive disorders and inflammatory mediators in patients undergoing laparoscopic colorectal cancer surgery

作者：司玉坤1曹海涛1梁彦秋2王景需2

英文作者：Si Yukun1 Cao Haitao1 Liang Yanqiu2 Wang Jingxu2

单位：1中国人民解放军陆军第八十二集团军医院体检中心，保定071000；2中国人民解放军陆军第八十二集团军医院麻醉科，保定071000

英文单位：1Physical Examination Center the Eighty-second Army Group Hospital of the Chinese People′s Liberation Army Baoding 071000 China; 2Department of Anesthesiology the Eighty-second Army Group Hospital of the Chinese People′s Liberation Army Baoding 071000 China

关键词：结直肠癌；右美托咪定；腹腔镜；围手术期；神经认知；炎性介质

英文关键词：Colorectalcancer;Dexmedetomidine;Laparoscopy;Perioperativeperiod;Neurocognition;Inflammatorymediators

• 摘要：

• 目的 探究右美托咪定对腹腔镜结直肠癌手术患者围手术期神经认知紊乱及炎性介质的影响。方法 选取2021年6月至2023年1月中国人民解放军陆军第八十二集团军医院收治的76例行腹腔镜结直肠癌手术患者，采用随机数字表法将患者分为对照组和观察组，各38例。对照组麻醉诱导前以0.9%氯化钠注射液静脉泵注；观察组麻醉诱导前以右美托咪定静脉泵注。比较2组患者麻醉前（T0）、苏醒时（T1）、出麻醉恢复室时（T2）、术后24 h（T3）认知功能。检测2组患者神经功能及炎性介质指标水平。结果 2组T1、T2时点蒙特利尔认知评估量表评分均低于T0时点，且观察组均高于对照组［（24.5±1.8）分比（22.4±2.2）分、（25.7±1.5）分比（23.3±2.0）分］（均P＜0.001）。2组T1、T2时点中枢神经特异性蛋白β、神经元特异性烯醇化酶水平均高于T0时点，且观察组均低于对照组（均P＜0.05）。2组T1、T2、T3时点C反应蛋白、肿瘤坏死因子α及白细胞介素6水平均高于T0时点，且观察组均低于对照组（均P＜0.05）。结论 腹腔镜结直肠癌手术患者使用右美托咪定可有效改善认知功能和神经功能，降低炎性介质水平。

• Objective  To investigate the effects of dexmedetomidine on perioperative neurocognitive disorders and inflammatory mediators in patients undergoing laparoscopic colorectal cancer surgery. Methods A total of 76 patients who underwent laparoscopic colorectal cancer surgery in the Eighty-second Army Group Hospital of the Chinese People′s Liberation Army from June 2021 to January 2023 were selected.According to the random number table method, the patients were divided into the control group and the observation group, with 38 cases in each group. The control group was given 0.9% sodium chloride injection by intravenous pump before anesthesia induction. The observation group was given dexmedetomidine intravenous pump before anesthesia induction. The cognitive function was compared between the two groups before anesthesia(T0), at recovery(T1), when leaving the postanesthesia care unit(T2) and 24 h after operation(T3).The levels of neurological function and inflammatory mediators in the two groups were detected. Results The Montreal Cognitive Assessment scores of the two groups at T1 and T2 were lower than those at T0, and the scores of the observation group were higher than those of the control group［(24.5±1.8) vs (22.4±2.2), (25.7±1.5) vs (23.3±2.0)］ (all P<0.001). The levels of central nervous system specific protein β and neuron specific enolase at T1 and T2 in the two groups were higher than those at T0, and those in the observation group were lower than those in the control group(all P<0.05). The levels of C-reactive protein, tumor necrosis factor-α and interleukin-6 at T1, T2 and T3 in the two groups were higher than those at T0, and those in the observation group were lower than those in the control group (all P<0.05). Conclusion Dexmedetomidine can effectively improve cognitive function and neurological function and reduce the level of inflammatory mediators in patients undergoing laparoscopic colorectal cancer surgery.