右美托咪定对胃肠手术患者的疗效分析
Analysis of Therapeutic Effect of Dexmedetomidine in Patients Undergoing Gastrointestinal Surgery
DOI: 10.12677/ACM.2023.13122782, PDF,   
作者: 马慧琴：青海大学研究生院，青海 西宁；贾国强*：青海大学附属医院急诊医学，青海 西宁
关键词: 胃肠外科手术；右美托咪定；胃肠功能；疗效和安全性；Gastrointestinal Surgical Procedures； Dexmedetomidine； Gastrointestinal Function； Effect and Safety
摘要: 右美托咪定在胃肠手术患者手术期间使用相关研究证明其有独到之处，其中在于患者术后胃肠道恢复，重建胃肠道屏障、缩短重症监护病房住院时间甚至住院时间，具有一定的抗炎能力也为胃肠道患者在早期喂养阶段创造了较为稳定的肠道环境，且在作为麻醉类药物时能减少其他麻醉类药物用量，同时提供了稳定的血流动力学状态，在这里，我们回顾了相关大量RCT实验也证明其在临床应用中的疗效，并探讨右美托咪定在临床应用中的安全性。
Abstract: The use of dexmedetomidine in gastrointestinal surgery patients during the operation has proved its unique features, including postoperative gastrointestinal recovery, reconstruction of gastroin-testinal barrier, shortening of hospital stay in intensive care unit or even hospital stay, and a certain anti-inflammatory ability, which also creates a more stable intestinal environment for gastrointes-tinal patients in the early feeding stage. In addition, when used as an anesthetic drug, it can reduce the dosage of other anesthetic drugs and provide a stable hemodynamic state. Here, we reviewed a large number of relevant RCT experiments that also proved its efficacy in clinical application, and discussed the safety of dexmedetomidine in clinical application.
文章引用：马慧琴, 贾国强. 右美托咪定对胃肠手术患者的疗效分析[J]. 临床医学进展, 2023, 13(12): 19764-19768. https://doi.org/10.12677/ACM.2023.13122782

参考文献

[1] Venn, R.M., Hell, J. and Grounds, R.M. (2000) Respiratory Effects of Dexmedetomidine in the Surgical Patient Requir-ing Intensive Care. Critical Care, 4, 302-308. [Google Scholar] [CrossRef] [PubMed]
[2] Aantaa, R. and Jalonen, J. (2006) Perioperative Use of alpha2-Adrenoceptor Agonists and the Cardiac Patient. European Journal of Anaesthesiology, 23, 361-372. [Google Scholar] [CrossRef] 
[3] Chen, C., Huang, P., Lai, L., Luo, C., Ge, M., Hei, Z., Zhu, Q. and Zhou, S. (2016) Dexmedetomidine Improves Gastrointestinal Motility after Laparoscopic Resection of Col-orectal Cancer: A Randomized Clinical Trial. Medicine (Baltimore), 95, e4295. [Google Scholar] [CrossRef] 
[4] 王峰, 秦环龙. 胃肠外科手术后肠道菌群改变: 肠道环境重建的临床意义[J]. 中华胃肠外科杂志, 2020, 23(Z1): 27-31.
[5] Jiang, L., Hu, M., Lu, Y., Cao, Y., Chang, Y. and Dai, Z. (2017) The Protective Effects of Dexmedetomidine on Ischemic Brain Injury: A Meta-Analysis. Journal of Clin-ical Anesthesia, 40, 25-32. [Google Scholar] [CrossRef] [PubMed]
[6] Zhang, W., Wang, R., Li, B., Zhao, Y., Liu, X. and Yuan, J. (2022) The Effect of Dexmedetomidine on Postoperative Nausea and Vomiting in Patients Undergoing Thoracic Sur-gery—A Meta-Analysis of a Randomized Controlled Trial. Frontiers in Surgery, 9, Article ID: 863249. [Google Scholar] [CrossRef] [PubMed]
[7] Qi, Y.P., Ma, W.J., Cao, Y.Y., Chen, Q., Xu, Q.C., Xiao, S., Lu, W.H. and Wang, Z. (2022) Effect of Dexmedetomidine on Intestinal Barrier in Patients Undergoing Gastrointestinal Sur-gery—A Single-Center Randomized Clinical Trial. Journal of Surgical Research, 277, 181-188. [Google Scholar] [CrossRef] [PubMed]
[8] Pang, G., Zhu, Y., Zhou, Y. and Tong, S. (2022) The Anesthetic Ef-fect and Safety of Dexmedetomidine in Cesarean Section: A Meta-Analysis. BioMed Research International, 2022, Arti-cle ID: 1681803. [Google Scholar] [CrossRef] [PubMed]
[9] 赵丹, 孙青, 肖华平, 等. 右美托咪定负荷剂量不同给药途径对腹腔镜结肠癌根治术患者苏醒期应激反应的影响[J]. 实用癌症杂志, 2023, 38(11): 1872-1876+1884.
[10] Takimoto, K., Ueda, T., Shimamoto, F., Kojima, Y., Fujinaga, Y., Kashiwa, A., Yamauchi, H., Matsuyama, K., Toyonaga, T. and Yoshikawa, T. (2011) Sedation with Dexmedetomidine Hydrochloride during Endoscopic Submucosal Dissection of Gastric Cancer. Digestive Endoscopy, 23, 176-181. [Google Scholar] [CrossRef] [PubMed]
[11] Wan, Q., Ding, W., Cui, X. and Zeng, X. (2018) CONSORT-Epidural Dexmedetomidine Improves Gastrointestinal Motility after Laparoscopic Colonic Resection Compared with Morphine. Medicine (Baltimore), 97, e11218. [Google Scholar] [CrossRef] 
[12] Lu, Y., Fang, P.P., Yu, Y.Q., Cheng, X.Q., Feng, X.M., Wong, G.T.C., Maze, M., Liu, X.S. and POGF Study Collaborators (2021) Effect of Intraoperative Dexmedetomidine on Recovery of Gastrointestinal Function after Abdominal Surgery in Older Adults: A Randomized Clinical Trial. JAMA Network Open, 4, e2128886. [Google Scholar] [CrossRef] [PubMed]
[13] 徐清华, 李中安. 右美托咪定超前镇痛对腹腔镜手术患者术后疼痛及应激反应的影响[J]. 河北医药, 2023, 45(19): 2920-2924.
[14] 刘颖, 李勇, 姜鲜. 食管癌根治术中应用大剂量右美托咪定的镇痛效果及对血清IL-6、TNF-α、MDA水平和SOD活性的影响[J]. 检验医学与临床, 2023, 20(16): 2387-2390.
[15] Wang, Z.X., Huang, C.Y., Hua, Y.P., Huang, W.Q., Deng, L.H. and Liu, K.X. (2014) Dexmedetomidine Reduces Intestinal and Hepatic Injury after Hepatectomy with Inflow Occlusion under General Anaesthesia: A Randomized Controlled Trial. British Journal of Anaesthesia, 112, 1055-1064. [Google Scholar] [CrossRef] [PubMed]
[16] Herbert, M.K., Roth-Goldbrunner, S., Holzer, P., et al. (2002) Clonidine and Dexmedetomidine Potently Inhibit Peristalsis in the Guinea Pig Ileum in Vitro. Anesthesiology, 97, 1491-1499. [Google Scholar] [CrossRef] [PubMed]
[17] Iirola, T., Vilo, S., Aantaa, R., et al. (2011) Dexme-detomidine Inhibits Gastric Emptying and Oro-Caecal Transit in Healthy Volunteers. British Journal of Anaesthesia, 106, 522-527. [Google Scholar] [CrossRef] [PubMed]
[18] 卜月, 席宏杰. 右美托咪定调控ERK1/2/HO-1信号通路对肝脏缺血再灌注损伤的影响[J]. 哈尔滨医科大学学报, 2023, 57(4): 360-365. [Google Scholar] [CrossRef] 
[19] 可丽楠. 右美托咪定的临床麻醉应用进展[J]. 中国城乡企业卫生, 2023, 38(11): 30-32.
[20] 高素琴, 郭宇峰. 右美托咪定联合丙泊酚在临床无痛胃镜麻醉中的应用效果[J]. 临床医学研究与实践, 2021, 6(24): 100-102.
[21] Abdul Hadi, B., Sbeitan, S.M. and Shakya, A.K. (2019) Fentanyl vs Fentanyl-Dexmedetomidine in Lumbar Foraminotomy Surgery. Therapeutics and Clinical Risk Management, 15, 885-890. [Google Scholar] [CrossRef] 
[22] 武庆涛, 张震. 右美托咪定对中老年脑出血患者术后谵妄发生率及记忆力的影响[J]. 临床心身疾病杂志, 2023, 29(5): 136-139.
[23] Cheung, C.W., Qiu, Q., Ying, A.C., Choi, S.W., Law, W.L. and Irwin, M.G. (2014) The Effects of Intra-Operative Dexmedetomidine on Postoperative Pain, Side-Effects and Recovery in Colorectal Surgery. Anaesthesia, 69, 1214-1221. [Google Scholar] [CrossRef] [PubMed]
[24] 陈妍, 郑东青, 黄丽洁. 右美托咪定联合地佐辛在行胸腔镜手术患者术后镇痛中的应用效果[J]. 基层医学论坛, 2023, 27(26): 68-70. [Google Scholar] [CrossRef] 

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