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目的:探讨右美托咪定对老年胃癌患者腹腔镜胃癌根治术后短期预后的影响。方法:选取2018年6月至2019年9月山西省肿瘤医院收治的60例老年胃癌患者作为研究对象,采用随机数字表法将患者分成观察组与对照组,每组各30例。全部患者均行腹腔镜胃癌根治术。对照组常规静脉麻醉,观察组在对照组麻醉方法基础上辅助以右美托咪定静脉输注,观察并比较两组患者的术中、术后一般情况、血流动力学及术后谵妄发生情况。结果:观察组患者术后肛门排气时间及住院时间均短于对照组[(72±10)h比(79±13)h,n t=8.384,n P=0.031;(11.0±1.7)d比(12.9±1.9)d,n t=7.404,n P=0.022];观察组与对照组腹腔引流时间分别为(8.4±2.8)d和(8.6±1.6)d,差异无统计学意义(n t=0.958,n P=1.092),引流量分别为(534±50)ml和(545±55)ml,差异无统计学意义(n t=0.847,n P=1.202)。与术前基础值相比,两组平均动脉压(MAP)在术中均较稳定;拔管时对照组MAP[(104±5)mmHg,1 mmHg=0.133 kPa]高于观察组[(92±7)mmHg](n t=7.383,n P<0.01),也高于同组术前MAP[(92±9)mmHg](n P<0.05)。观察组术中心率低于术前及对照组同一时段的心率。观察组术后7 d内谵妄和可疑谵妄的发生率分别为3% (1/30)和7%(2/30),对照组分别为10%(3/30)和13%(4/30),两组谵妄和可疑谵妄发生率比较,差异均有统计学意义(n χ2值分别为9.394、7.485,均n P<0.05)。n 结论:右美托咪定能够降低老年胃癌患者腹腔镜胃癌根治术后谵妄的发生率,使血流动力学更稳定,康复更快。“,”Objective:To investigate the effects of dexmedetomidine on short-term prognosis in elderly patients with gastric cancer after laparoscopic radical gastrectomy.Methods:A total of 60 elderly patients with gastric cancer admitted to Shanxi Provincial Cancer Hospital from June 2018 to September 2019 were selected as the research objects. The patients were randomly divided into the observation group and the control group according to random number method, 30 cases in each group. All patients underwent laparoscopic radical gastrectomy. The patients in the control group received routine intravenous anesthesia, and the patients in the observation group were assisted with intravenous infusion of dexmedetomidine on the basis of anesthesia in the control group. The general situation during and after surgery, hemodynamics and postoperative delirium of patients in the two groups were observed and compared.Results:The anal exhaust time and hospitalization time in the observation group was shorter than that in the control group [(72±10) h vs. (79±13) h, n t = 8.384, n P = 0.031; (11.0±1.7) d vs. (12.9±1.9) d, n t = 7.404, n P = 0.022]. While the time of abdominal drainage was (8.4±2.8) d and (8.6±1.6) d, respectively in the observation group and the control group, and the difference was not statistically significant (n t = 0.958, n P = 1.092); the volume of abdominal drainage was (534±50) ml and (545± 55) ml, respectively, and the difference was not statistically significant (n t = 0.847, n P = 1.202). Compared with the preoperative baseline, the mean arterial pressure (MAP) in the two groups was stable during the operation. At extubation, the MAP in the control group [(104±5) mmHg, 1 mmHg = 0.133 kPa] was higher than that in the observation group [(92±7) mmHg] (n t = 7.383, n P < 0.01); in the control group, the MAP at extubation was also higher compared with the preoperative MAP [(92±9) mmHg] ( n P < 0.05). The heart rate in the observation group was lower than that before surgery and the same period in the control group.The incidence rate of delirium and suspicious delirium was 3% (1/30) and 7% (2/30) in the observation group, 10% (3/30) and 13% (4/30) in the control group within 7 d after surgery, and there were statistically significant differences in delirium and suspicious delirium between the two groups ( n χ2 = 9.394, 7.485, all n P < 0.05).n Conclusion:Dexmedetomidine can reduce the incidence of delirium in elderly patients with gastric cancer after laparoscopic radical gastrectomy, and make the hemodynamics more stable and recovery faster.