右美托咪定对肺癌患者手术期间肺内分流及炎性反应的影响

发布时间：2018-04-28 11:12

本文选题：右美托咪定 + 单肺通气　；参考：《中国医院药学杂志》2015年09期

【摘要】：目的:研究右美托咪定对肺癌根治术患者手术期间肺内分流及炎性反应的影响。方法:60例择期行右上叶肺癌根治术患者,ASA I~II级,随机分为2组(n=30):右美托咪定组(D),于气管插管前10 min泵注负荷量1μg·kg-1,并按0.5μg·kg-1·h-1持续泵注至关胸;空白组(C组),给予等容量生理盐水作对照。分别于麻醉双肺通气后15 min(T0)、单肺通气15min(T1)、单肺通气1 h(T2)、恢复双肺通气15 min(T3)经颈内静脉、桡动脉采血做血气分析,计算肺内分流(Qs/Qt)以及酶联免疫法检测IL-6、IL-10浓度。结果:与T0时比较,T1、T2时2组肺内分流及IL-6、IL-10有统计学差异(P0.05);与C组比较,D组T1、T2时肺内分流减少及IL-6、IL-10的浓度降低(P0.05)。结论:右美托咪定对肺内分流有一定的改善作用,且能抑制手术过程中的炎症反应,对围术期进行肺保护起到积极作用。
[Abstract]:Aim: to study the effects of dexmetomidine on intrapulmonary shunt and inflammatory response during radical resection of lung cancer. Methods A total of 60 patients with right upper lobe lung cancer undergoing radical mastectomy were randomly divided into 2 groups: dexmetomidine group (n = 10) was injected with 1 渭 g / kg -1 pump 10 min before tracheal intubation, and was continuously injected with 0.5 渭 g / kg-1 / h ~ (-1) pump to the closed chest. The blank group was treated with normal saline of equal volume as control group. Blood samples were collected from internal jugular vein and radial artery for blood gas analysis 15 min after anesthesia, 15 min after one-lung ventilation, 15 min after one-lung ventilation, 1 h after one-lung ventilation, and 15 min after restoration of bilateral pulmonary ventilation. The concentration of IL-6 IL-10 was measured by enzyme-linked immunosorbent assay (Elisa). Results: there were significant differences in intrapulmonary shunt and IL-6 IL-10 between the two groups at T _ 1 T _ 2 and T _ 1 / T _ 2 compared with that at T _ (0), and the decrease of intrapulmonary shunt and the decrease of IL-10 concentration at T _ (1) and T _ 2 in D group were compared with those in C group (P < 0.05). Conclusion: dexmetomidine can improve intrapulmonary shunt, inhibit inflammatory reaction during operation, and play a positive role in lung protection during perioperative period.
【作者单位】：宁波市第一医院;
【基金】：浙江省医学会临床科研基金项目(编号:20114ZYC-A05)
【分类号】：R614;R734.2

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