摘要

摘要】
目的：对行食管癌根治术的患者采取右美托咪定复合全身麻醉的方式，探讨其对患者苏醒期躁动以及术后认知功能的保护作用。

方法：选择2022年8月至2025年4月期间在我院行食管癌根治术的食管癌患者76例，通过数字表法随机分为两组，其中对照组给予全身麻醉操作后联合使用生理盐水，观察组在全身麻醉干预后加入右美托咪定。比较两组患者的麻醉相关时间（麻醉诱导时间、苏醒时间、气管拔管时间）、苏醒期躁动发生率、术后认知功能评分及血清神经功能标志物（血清神经元特异性烯醇化酶(NSE)、神经生长因子(NGF)和脑源性神经营养因子(BDNF)）水平。

结果：观察组患者麻醉相关时间更短（P＜0.05）；苏醒期躁动情况的发生几率更低（P＜0.05）；观察组患者在术后干预的第3天及第7天，MoCA评分相比对照组更高（P＜0.05）；观察组患者术后第3天和第7天的NSE水平更低，NGF、BDNF水平则更高（P＜0.05）。

结论：食管癌根治术患者全麻中联合右美托咪定，可缩短麻醉时间，降低躁动几率，加快术后认知恢复，减少神经损伤，具临床推广潜力。

关键词：【关键词】右美托咪定；全身麻醉；食管癌根治术；躁动；认知功能

ABSTRACT

[Abstract]
Objective: To investigate the effects of dexmedetomidine combined with general anesthesia on emergence agitation and postoperative cognitive function in patients undergoing radical esophagectomy.

Methods: A total of 76 esophageal cancer patients who underwent radical esophagectomy in our hospital from August 2022 to August 2024 were selected and randomly divided into two groups using a random number table. The control group received general anesthesia followed by normal saline, while the observation group received dexmedetomidine in addition to general anesthesia. The anesthesia-related times (induction time, emergence time, extubation time), incidence of emergence agitation, postoperative cognitive function scores, and levels of serum neurological markers (neuron-specific enolase [NSE], nerve growth factor [NGF], and brain-derived neurotrophic factor [BDNF]) were compared between the two groups.

Results: The observation group exhibited shorter anesthesia-related times (P < 0.05), a lower incidence of emergence agitation (P < 0.05), higher Montreal Cognitive Assessment (MoCA) scores on postoperative days 3 and 7 (P < 0.05), lower NSE levels, and higher NGF and BDNF levels on postoperative days 3 and 7 (P < 0.05) compared to the control group.

Conclusion  : The combination of dexmedetomidine with general anesthesia in patients undergoing radical esophagectomy can shorten anesthesia duration, reduce agitation, accelerate postoperative cognitive recovery, and mitigate neurological damage, demonstrating potential for clinical application.

Key words: [Keywords] Dexmedetomidine; General anesthesia; Radical esophagectomy; Agitation; Cognitive function