不同剂量右美托咪定对老年腹腔镜手术患者镇痛与应激及免疫功能的影响分析

发布时间：2018-01-29 10:08

本文关键词： 右美托咪定腹腔镜手术镇痛应激免疫功能　出处：《中国临床药理学杂志》2015年17期 　论文类型：期刊论文

【摘要】：目的探讨不同剂量右美托咪定对老年腹腔镜手术患者镇痛、应激以及免疫功能的影响。方法将126例腹腔镜手术患者随机分为低剂量组42例、中剂量组42例和高剂量组42例。低、中、高3个剂量组分别在麻醉前15 min予以静脉注射0.2,0.4,0.6μg·kg-1·h-1右美托咪定。比较3组患者术前、术后3,8,24 h的镇痛评分、舒张压、收缩压、血糖、心率以及CD4、CD8、CD4/CD8水平。结果术前和术后24 h,3组患者的镇痛评分比较差异无统计学意义(P0.05)。术前和术后24 h,3组患者的舒张压、收缩压、血糖、心率比较差异无统计学意义(P0.05)。术后3,8 h,中、高剂量组患者的镇痛评分明显高于低剂量组(P0.05)。术后3,8 h,中、高剂量组的舒张压、收缩压、血糖、心率水平明显优于低剂量组(P0.05)。术前和术后,3组患者的的CD4水平比较差异无统计学意义(P0.05)。术前和术后3 h,3组患者的CD8、CD4/CD8水平比较差异无统计学意义(P0.05)。术后8,24 h,中、高剂量组患者的CD8水平明显低于低剂量组,且CD4/CD8比值明显优于低剂量组(P0.05)。结论用0.4,0.6μg·kg-1·h-1右美托咪定对老年腹腔镜手术患者有着更为明显的镇痛功效,可减轻应激反应,改善患者的免疫功能,值得广泛推广使用。
[Abstract]:Objective to investigate the effects of dexmetidine on analgesia, stress and immune function in elderly patients undergoing laparoscopic surgery. Methods 126 patients undergoing laparoscopic surgery were randomly divided into low dose group (n = 42) and low dose group (n = 42). 42 cases in the middle dose group and 42 cases in the high dose group. The low, middle and high dose groups were injected with 0.2g 0.4 intravenously 15 min before anesthesia. The analgesic scores, diastolic blood pressure, blood glucose, heart rate and CD _ 4 / CD _ 8 were compared between the three groups. Results there was no significant difference in analgesic scores between the three groups before and 24 hours after operation (P 0.05). The diastolic blood pressure of the three groups was 24 hours after operation and 24 hours after operation. There was no significant difference in systolic blood pressure, blood glucose and heart rate. The analgesic score of the patients in the middle and high dose group was significantly higher than that in the low dose group at 8 hours postoperatively. At 8 h, the diastolic blood pressure, systolic blood pressure, blood glucose and heart rate in the middle and high dose group were significantly higher than those in the low dose group (P 0.05). There was no significant difference in the level of CD4 between the three groups (P 0.05). The CD8 of the 3 groups before and 3 hours after operation. There was no significant difference in the level of CD4/CD8 between the two groups (P 0.05). The CD8 level in the middle and high dose group was significantly lower than that in the low dose group at 8h after operation. The ratio of CD4/CD8 was better than that of low dose group (P 0.05). 0.6 渭 g 路kg-1 路h-1 dexmetomidine has more obvious analgesic effect on elderly patients undergoing laparoscopic surgery. It can alleviate stress reaction and improve the immune function of patients. It is worth popularizing and using widely.
【作者单位】：温州医科大学附属第一医院麻醉疼痛科;
【基金】：浙江省医药卫生平台骨干人才计划基金资助项目(2011RCB026)
【分类号】：R614
【正文快照】： 皮治兵,林海,徐旭仲(温州医科大学附属第一医院麻醉疼痛科,浙江温州325000)PI Zhi-bing,LIN hai,XU Xu-zhong(Department of Anesthesia Pain,Wenzhou Medical College FirstAffiliated Hospital,Wenzhou 325000,Zhejiang Pronvince,China)腹腔镜手术具备恢复快、创伤小、住院

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