目的 分析右美托咪定对气管插管全麻醉妇科腹腔镜手术患者应激的影响。方法 选取2019年5月—2022年5月行气管插管全麻醉妇科腹腔镜手术的患者90例,按随机数字表法分为3组,分别为A组（右美托咪定0.2 μg/kg,n=30）,B组（右美托咪定0.4 μg/kg,n=30）,C组（右美托咪定0.6 μg/kg,n=30）。对比分析各组患者诱导前5 min、插管后5 min、手术完成时应激指标、血清去甲肾上腺素和肾上腺素水平差异。结果 3组患者在诱导前5 min、插管后5 min以及手术完成时 SpO₂水平比较,差异均无统计学意义（P>0.05）;3组患者在诱导前5 min和插管后5 min手术完成时的平均动脉压（MAP）和心率（HR）比较差异均无统计学意义（P>0.05）,而在手术完成时,MAP和HR比较,差异有统计学意义（P<0.05）。3组患者在诱导前5 min的血清去甲肾上腺素水平比较,差异均无统计学意义（P>0.05）;在插管后5 min、手术完成时血清去甲肾上腺素水平比较,B组显著低于其他各组（P<0.05）。3组患者在诱导前5 min的肾上腺素水平比较,差异均无统计学意义（P>0.05）;在插管后5 min、手术完成时肾上腺素水平比较,B组显著低于其他各组（P<0.05）。结论 右美托咪定可以减少气管插管全麻醉妇科腹腔镜手术患者的应激反应,降低血清去甲肾上腺素与肾上腺素水平,值得临床推广使用。

Objective To investigate the effects of dexmedetomidine on stress in patients undergoing gynecological laparoscopic surgery under general anesthesia with endotracheal intubation. Methods From May 2019 to May 2022, a total of 90 patients undergoing gynecological laparoscopic surgery under general anesthesia with endotracheal intubation were selected and randomly divided into 3 groups, namely Group A （dextrometomidine 0.2 μg/kg, n=30）, Group B （dexmedetomidine 0.4 μg/kg, n=30）, and Group C （dexmedetomidine 0.6 μg/kg, n=30）. The differences of stress index, serum norepinephrine, and adrenaline levels 5 min before induction, 5 min after intubation, and at the completion of surgery were analyzed. Results There was no significant difference in SpO₂ level among the three groups at three time points （P>0.05）. There were no significant differences in MAP and HR among the three groups 5 min before induction and 5 min after intubation （P>0.05）, except at the completion of surgery （P<0.05）. There was no significant difference in serum norepinephrine level among the three groups 5 min before induction （P>0.05）, but the level in Group B was significantly lower than those in other groups 5 min after intubation and at the completion of surgery （P<0.05）. The adrenaline level varied in the same manner as the norepinephrine level （P<0.05）. Conclusion Dexmedetomidine can reduce the stress response of patients undergoing gynecological laparoscopic surgery under general anesthesia with endotracheal intubation, and decrease the levels of serum norepinephrine and adrenaline, which is worthy of clinical promotion.