右美托咪定对老年患者下肢手术中止血带所致氧化应激及炎症反应的影响

发布时间：2018-04-28 14:00

本文选题：右美托咪定 + 氧化应激　；参考：《华中科技大学学报(医学版)》2015年03期

【摘要】：目的探讨右美托咪定对老年患者下肢手术中止血带所致氧化应激及炎症反应的影响。方法将168例行下肢手术平均年龄(67.6±6.4)岁(60~84岁)的老年患者,分为右美托咪定组(n=62)、丙泊酚组(n=52)和对照组(n=54),均采用蛛网膜下腔阻滞麻醉联合硬膜外麻醉。完成穿刺后,右美托咪定组患者10min内给予负荷量1μg/kg右美托咪定静脉输注,后采用0.5μg/(kg·h)维持至术毕;丙泊酚组患者给予丙泊酚靶控静脉输注,起始靶浓度1.0μg/mL,与效应室浓度平衡3min后,以0.2μg/mL递增;对照组患者给予与右美托咪定组同剂量、同速率生理盐水输注。分别于使用止血带前(T0),松开止血带后10min(T1),30min(T2)和60min(T3)时,采用ELISA法检测血清超氧化物歧化酶(SOD)、丙二醛(MDA)、C-反应蛋白(CRP)、白细胞介素-8(IL-8)和人肿瘤坏死因子-α(TNF-α)。结果 T1~T3时点,右美托咪定组和丙泊酚组患者血清SOD含量均高于对照组,MDA和CRP含量均低于对照组(均P0.05);T2、T3时点,右美托咪定组患者SOD含量高于丙泊酚组,MDA和CRP含量低于丙泊酚组(均P0.05);T1~T3时点,右美托咪定组和丙泊酚组患者血清IL-8和TNF-α含量均低于对照组(均P0.05),右美托咪定组患者血清IL-8和TNF-α含量均低于丙泊酚组(均P0.05)。结论右美托咪定应用于下肢手术老年患者,可有效减少由于使用止血带所导致的氧化应激及炎症反应。
[Abstract]:Objective to investigate the effects of dexmetomidine on oxidative stress and inflammatory response induced by tourniquet during lower limb surgery in elderly patients. Methods 168 elderly patients with lower extremity operation with an average age of 67.6 卤6.4 years old or 60 to 84 years old were divided into two groups: dexmetomidine group (n = 62), propofol group (n = 52) and control group (n = 54). All patients were treated with subarachnoid block anesthesia combined with epidural anesthesia. After the puncture, the patients in the dexmetomidine group received 1 渭 g/kg dexmetomidine intravenously infusion in 10min, followed by 0.5 渭 g/(kg / h), and the propofol group received target controlled intravenous infusion of propofol, the initial target concentration of which was 1.0 渭 g / mL, after balancing 3min with the concentration of the effector chamber, the patients in the propofol group were given propofol target-controlled intravenous infusion. The patients in the control group were given the same dose and the same rate of normal saline infusion as the dexmetomidine group. Serum superoxide dismutase (SOD), malondialdehyde (MDA-C), interleukin-8 (IL-8) and human tumor necrosis factor- 伪 TNF- 伪 (TNF- 伪) were detected by ELISA method before tourniquet was used, 10 min after release of tourniquet, and 10 min after release of tourniquet. Results at the T1~T3 time point, the serum SOD levels in the dexmetomidine group and propofol group were significantly higher than those in the control group (P 0.05) and the levels of CRP were lower than those in the control group (P 0.05). The levels of SOD and CRP in dexmetomidine group were higher than those in propofol group. The levels of serum IL-8 and TNF- 伪 in the dexmetomidine group and propofol group were lower than those in the control group (all P 0.05), and the levels of serum IL-8 and TNF- 伪 in the dexmetomidine group were lower than those in the propofol group (all P 0.05). Conclusion dexmetomidine can effectively reduce oxidative stress and inflammation caused by tourniquet in elderly patients undergoing lower extremity surgery.
【作者单位】：河南省新乡市中心医院麻醉科;河南省焦作市焦煤中央医院麻醉科;
【分类号】：R614

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