右美托咪定联合乌司他丁对单肺通气肺癌患者血清促炎因子水平的影响

发布时间：2018-02-02 04:58

本文关键词： 肺癌单肺通气肺叶切除术右美托咪定乌司他丁麻醉肺功能　出处：《山东医药》2017年37期 　论文类型：期刊论文

【摘要】：目的探讨右美托咪定联合乌司他丁对单肺通气肺癌患者血清促炎因子水平的影响。方法选择经单肺通气行肺叶切除术的患者80例,随机均分为四组。各组均给予全麻诱导,诱导前30 min,D组以1μg/(kg·h)持续静脉泵注浓度为2μg/mL的右美托咪定注射液,诱导结束后按0.5μg/(kg·h)静脉泵注100 mL至手术结束;U组缓慢输注5 000 U/kg乌司他丁注射液100 mL;D+U组经不同通道输注5 000 U/kg的乌司他丁注射液及4μg/mL右美托咪定注射液各50 mL;N组缓慢滴注0.9%的氯化钠注射液100 mL。分别于麻醉诱导前30 min(T_1)、手术开始后2 h(T_2)、手术后24 h(T_3)、手术后48 h(T_4)用ELISA法检测血清白细胞介素1β(IL-1β)、髓过氧化物酶(MPO)、巨噬细胞炎性蛋白2(MIP-2)、肿瘤坏死因子α(TNF-α)及核因子κB(NF-κB);用RT-PCR法检测血清IL-1β、MPO及NF-κB的mRNA表达。结果除T_1时点外,T_(2~4)时点D+U组血清IL-1β、MPO、MIP-2、TNF-α及NF-κB水平与其他三组比较,P均0.05;且D+U组IL-1β、MPO及NF-κB的mRNA表达与其他三组比较,P均0.05。结论右美托咪定联合乌司他丁可降低单肺通气肺癌患者术中及术后48 h内血清促炎因子水平。
[Abstract]:Objective to investigate the effect of dexmetomidine combined with ulinastatin on serum proinflammatory factor levels in patients with lung cancer undergoing single lung ventilation. Methods 80 patients undergoing lobectomy with single lung ventilation were selected. All groups were randomly divided into four groups. Each group was induced by general anesthesia. 30 min before induction, the D group was continuously injected with 2 渭 g / mL dexmetomidine injection 30 min before induction. After induction, 100 mL was injected intravenously at 0.5 渭 g / kg 路h to the end of operation. Group U received 5 000 U / kg ulinastatin (100 mL) slowly; In group D, 5 000 U / kg ulinastatin injection and 4 渭 g / mL dexmetomidine injection were injected through different channels 50 mL each. In group N, 0.9% sodium chloride injection was infused slowly at 30 min before induction of anesthesia. Serum IL-1 尾 and myeloperoxidase (MPO) were detected by ELISA method at 24 hours after operation and 48 hours after operation. Macrophage inflammatory protein 2 (MIP-2), tumor necrosis factor 伪 (TNF- 伪) and nuclear factor- 魏 B (NF- 魏 B); The expression of mRNA in serum IL-1 尾 -MPO and NF- 魏 B was detected by RT-PCR method. The levels of MIP-2TNF- 伪 and NF- 魏 B were 0.05 compared with the other three groups. The mRNA expressions of IL-1 尾 -MPO and NF- 魏 B in D U group were compared with those in the other three groups. Conclusion dexmetomidine combined with ulinastatin can reduce the level of serum proinflammatory factor in patients with lung cancer during and 48 hours after single lung ventilation.
【作者单位】：攀枝花学院附属医院;南京军区南京总医院;
【基金】：四川省医学青年创新课题(Q15052)
【分类号】：R734.2
【正文快照】： 在临床部分肺部疾病(肺癌、慢性阻塞性肺部疾病等)患者需选择机械通气(MV)治疗。长时间大潮气量MV或因使用不恰当的通气模式常导致肺泡及肺间质水肿,肺毛细血管通透性改变,继发呼吸机相关性肺损伤(VILI),继而发展为急性肺损伤或急性呼吸窘迫综合征(ARDS),最终导致多器官功能衰

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