右美托咪定对单肺通气患者动脉血气和炎性因子的影响

发布时间：2018-03-25 04:26

本文选题：右美托咪定　切入点：单肺通气　出处：《临床麻醉学杂志》2017年11期

【摘要】：目的探讨右美托咪定对单肺通气(OLV)患者动脉血气和炎性因子的影响。方法选择择期肺癌根治术患者62例,性别不限,年龄34~69岁,ASAⅠ或Ⅱ级。按照收治先后顺序分成观察组和对照组,每组31例。所有患者静脉注射舒芬太尼0.3~0.5μg/kg、丙泊酚1.5~2.5mg/kg、咪达唑仑0.5 mg/kg、罗库溴铵0.9 mg/kg行麻醉诱导;静脉输注丙泊酚6~8 mg·kg~(-1)·h~(-1)、瑞芬太尼0.1~0.5μg·kg~(-1)·min~(-1),间断静脉注射顺式阿曲库铵进行麻醉维持。观察组患者于麻醉诱导前10min静脉输注右美托咪定1.0g/kg,10min输注完,之后维持0.5μg·kg~(-1)·h~(-1)速率输注至手术结束前30min。对照组则输注等量的生理盐水。分别于OLV前即刻(T0)、OLV 1h后(T1)、OLV结束时(T2)采集桡动脉血,检测血气(pH、PaO_2、PaCO_2)和炎性因子(TNF-α和IL-6)。记录两组手术结束后丙泊酚用量。结果与T0时比较,T1、T2时两组pH、PaO_2明显降低,PaCO_2明显升高,TNF-α和IL-6含量明显升高(P0.05);T1、T2时观察组PaO_2明显高于对照组(P0.05),PaCO_2明显低于对照组(P0.05),TNF-α和IL-6含量明显低于对照组(P0.05)。两组围术期顺式阿曲库铵用量和瑞芬太尼用量差异无统计学意义,观察组丙泊酚用量明显低于对照组(P0.05)。结论右美托咪定有助于维持单肺通气患者术中血气稳定,减轻单肺通气引起的炎症反应。
[Abstract]:Objective to investigate the effects of dexmetomidine on arterial blood gas and inflammatory factors in patients with single lung ventilation (OLVV). The patients were divided into observation group (n = 31) and control group (n = 31). All patients received intravenous injection of sufentanil (0.3 渭 g / kg), propofol (1.5 mg / kg), midazolam (0.5 mg / kg), rocuronium (0.9 mg / kg). Intravenous infusion of propofol (6mg / kg) -1) and remifentanil (0.1 ~ 0.5 渭 g / kg ~ (-1)) 路min ~ (-1) / min were maintained by intermittent intravenous injection of cis-atracurium. The patients in the observation group were given dexmetomidine 1.0 g / kg / kg for 10 minutes before anesthesia induction, and the patients in the observation group were given dexmetoimidine (1.0 g / kg) 10 minutes before anesthesia induction, and the patients in the observation group were given intravenous infusion of dexmetomidine (1.0 g / kg) for 10 minutes. The radial artery blood was collected at 0.5 渭 g 路kg ~ (-1) 路h ~ (-1) 路h ~ (-1)) and 30 min before operation. The control group was given the same amount of normal saline. The radial artery blood was collected at the end of T _ (1) and T _ (1) T _ (1) and T _ (2) at the end of OLV immediately before OLV. The levels of propofol in two groups after operation were recorded. Results compared with T _ 1 T _ 2 group, the pH Pao _ 2 of two groups significantly decreased and the content of Paco _ 2 and IL-6 increased significantly. The PaO_2 of observation group was significantly higher than that of control group at the end of operation (P _ (0.05)) and T _ (1) T _ (2), compared with that at T _ (1) T _ (2), P0. 05% T _ (1) T _ (2) was significantly higher in observation group than in control group (P < 0. 05). The contents of TNF- 伪 and IL-6 in group P0.05 were significantly lower than those in control group. There was no significant difference in the dosage of cis atracurium and remifentanil between the two groups during perioperative period. Conclusion the dosage of propofol in the observation group is significantly lower than that in the control group (P 0.05). Conclusion dexmetomidine is helpful to maintain blood gas stability in patients with single lung ventilation and to alleviate the inflammatory reaction induced by single lung ventilation.
【作者单位】：江苏省靖江市人民医院麻醉科;
【分类号】：R614

【相似文献】