右美托咪定、丙泊酚镇静用于高龄患者腹腔镜胆囊切除术麻醉维持中的效果及其对内皮细胞功能的影响
常静1 ，周文涛2 *
（1.西安电力中心医院，陕西 西安，710032；2.陕西省第二人民医院，陕西 西安，710005）
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摘要：
目的 探讨右美托咪定、丙泊酚用于高龄患者腹腔镜胆囊切除术（LC）麻醉维持中的效果及对血管内皮细胞（VECs）功 能的影响。方法 将我院行LC 治疗的高龄患者116 例，根据麻醉方法分为右美托咪定组（使用右美托嘧定维持麻醉）和丙泊 酚组（使用丙泊酚维持麻醉），各58 例。比较两组的麻醉效果及VECs 功能变化。结果 右美托咪定组麻醉后心率、收缩压、舒 张压及VECs 功能指标（P-选择素、ICAM-1、TM 和ET-1）、术后清醒时间、自主呼吸恢复时间、拔管时间、VAS 评分、术后 Ramsay 评分均明显优于丙泊酚组（P<0.05）。结论 对于高龄患者LC 中的麻醉维持，右美托咪定相比于丙泊酚具有更好的镇 静、镇痛效果，可有效维持患者的血流动力学稳定、保护内皮细胞功能。
关键词：腹腔镜胆囊切除术；右美托咪定；丙泊酚；麻醉；内皮细胞功能
中图分类号：R614文献标志码：A文章编号：2096-1413(2018)05-0097-02
Effect of dexmedetomidine and propofol on anesthesia maintenance in elderly patients undergoing LC and their influence on endothelial cell function
CHANG Jing1, ZHOU Wen-tao 2 *
(1. Xi``an Electric Power Center Hospital, Xi``an 710032; 2. Shaanxi Second Provincial People``s Hospital,
Xi``an 710005, China)
ABSTRACT: Objective To investigate the effect of dexmedetomidine and propofol on the maintenance of anesthesia in elderly patients undergoing LC and their influence on VECs function. Methods One hundred and sixteen elderly patients undergoing LC in our hospital were divided into dexmedetomidine group (using dexmedetomidine to maintain anesthesia) and propofol group (using propofol to maintain anesthesia) according to the anesthetic methods, with 58 cases in each group. The anesthetic effects and the diversification of VECs function in the two groups were compared. Results The HR, SBP, DBP and VECs function indexes (P-selectin, ICAM-1,TM and ET-1), postoperative sober time, spontaneous breathing recovery time, extubation time, VAS score, Ramsay sedation score of the dexmedetomidine group were better than those of the propofol group (P<0.05). Conclusion For the maintenance of anesthesia in elderly patients with LC, dexmedetomidine has better sedative and analgesic effects than propofol, and it can effectively maintain the hemodynamic stability and protect endothelial cell function.
KEYWORDS: LC; dexmedetomidine; propofol; anesthesia; endothelial cell function
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