不同剂量右美托咪定对妇科腹腔镜手术围术期炎症因子的影响

发布时间：2018-04-27 08:11

本文选题：右美托咪定 + 妇科腹腔镜　；参考：《临床麻醉学杂志》2015年04期

【摘要】：目的探讨不同剂量右美托咪定对妇科腹腔镜手术围术期炎症因子的影响。方法选择2012年1月至2013年12月择期妇科腹腔镜手术患者90例,按照随机数字表法将其分为高剂量右美托咪定组(D1组)、低剂量右美托咪定组(D2组)和对照组(C组),每组30例。D1组和D2组分别于麻醉诱导后持续静脉输注右美托咪定0.5和0.2μg·kg-1·h-1,C组则以等容量生理盐水代替。记录麻醉诱导前10 min(T1)、气管插管后1 min(T2)、气腹后1 min(T3)、术毕(T4)的MAP和HR,并检测血清TNF-α、IL-6、IL-10水平。结果与T1时比较,T2~T4时D2组和C组MAP明显升高,D1组HR明显减慢,T2、T3时C组HR明显增快(P0.05)。与C组比较,T2~T4时D1组和D2组MAP明显降低,HR明显减慢(P0.05)。与T1时比较,T2~T4时三组TNF-α、IL-6和IL-10水平明显升高(P0.05)。与C组比较,T2~T4时D1组和D2组TNF-α和IL-6水平明显降低,但D1组IL-10水平明显升高,T2、T3时D2组IL-10水平明显降低(P0.05)。结论持续输注右美托咪定可减轻妇科腹腔镜手术围术期炎症反应,且0.5μg·kg-1·h-1较0.2μg·kg-1·h-1更为明显。
[Abstract]:Objective to investigate the effect of different doses of dexmetomidine on perioperative inflammatory factors in gynecological laparoscopic surgery. Methods from January 2012 to December 2013, 90 patients with gynecological laparoscopic surgery were selected. According to the random number table method, they were divided into high dose dexmetomidine group (D 1 group), low dose right metoimidine group (D 2 group) and control group C group (30 cases in each group. D1 group and D2 group received continuous intravenous infusion of dexmetomide after anesthesia induction, respectively. 0. 5 and 0. 2 渭 g kg-1 h-1 C groups were replaced by isobaric saline. The MAP and HRT were recorded 10 min before anesthesia induction, 1 min after tracheal intubation, 1 min after pneumoperitoneum, 1 min after pneumoperitoneum, and 1 min after operation. The serum TNF- 伪 IL-6 IL-10 levels were measured. Results compared with T 1, MAP in D2 group and C group were significantly increased. HR in D 1 group was significantly lower than that in T 2 T 3 group and T 2 T 3 group (P 0.05). Compared with group C, MAP decreased significantly in D1 and D2 groups at T2T4, and HR decreased significantly in group D1 and D2. Compared with T1, the levels of TNF- 伪 IL-6 and IL-10 in T2T4 group increased significantly (P 0.05). Compared with group C, the levels of TNF- 伪 and IL-6 in D1 and D2 groups were significantly lower than those in group C, but the level of IL-10 in group D1 was significantly higher than that in group T _ 2T _ 3. The level of IL-10 in group D _ 2 was significantly lower than that in group D _ 2 at T _ 2T _ 3. Conclusion continuous infusion of dexmetidine can alleviate perioperative inflammation in gynecological laparoscopic surgery, and 0.5 渭 g kg-1 h-1 is more obvious than 0.2 渭 g kg-1 h-1.
【作者单位】：福建省福鼎市医院麻醉科;
【分类号】：R614

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