静脉泵注右美托咪定在肺癌患者开胸肺叶切除术中的应用效果

发布时间：2018-04-29 07:07

本文选题：肺肿瘤 + 右美托咪定　；参考：《山东医药》2017年29期

【摘要】：目的探讨右美托咪定在肺癌患者开胸肺叶切除术中的应用效果。方法将择期行开胸肺叶切除术的60例患者随机均分为对照组与观察组,观察组于麻醉诱导前静脉泵注0.6μg/kg右美托咪定10 min,对照组给予等量的生理盐水泵注,诱导与麻醉方法相同。记录两组手术时间、单肺通气时间及输液量、失血量;于麻醉诱导前(T_0)、气管插管前(T_1)、气管插管后(T_2)、切皮时(T_3)、单肺通气0.5 h(T_4)、单肺通气1 h(T_5)及手术结束时(T_6)采集两组动脉血,分析呼吸指数(RI)、氧合指数(OI)及肺血分流率(Qs/Qt);记录上述各时间点末梢灌注指数(TPI)、低频功率(LF)及高频功率(HF);记录上述各时间点心率变异性(HRV)、心率(HR)、收缩压(SBP)及舒张压(DBP)。结果两组手术时间、单肺通气时间、输液量、失血量比较,P均0.05。与对照组相比,观察组T_3~T_6时TPI值升高(P均0.05);T_4~T_5时RI、LF/HF、Qs/Qt降低,OI升高(P均0.05);与T_0比较,T_1~T_5时点两组HRV、HR、SBP、DBP均降低,T_6时点观察组HRV升高,对照组HRV、DBP升高(P均0.05);观察组T_6时点SBP、DBP低于对照组(P均0.05)。结论静脉泵注右美托咪定可减轻肺癌患者肺叶切除术中单肺通气造成的肺损伤,改善患者微循环,抑制围术期手术刺激对心血管系统的干扰。
[Abstract]:Objective to evaluate the effect of dexmetomidine on lobectomy in patients with lung cancer. Methods Sixty patients undergoing open lobectomy were randomly divided into control group and observation group. The control group received 0.6 渭 g/kg dexmetomidine for 10 minutes before anesthesia induction, and the control group was given the same amount of normal saline pump as the anesthetic method. The time of operation, the time of single lung ventilation, the amount of transfusion and the amount of blood lost were recorded. Arterial blood was collected from two groups before anesthesia induction, before induction of anesthesia, before intubation, after intubation, after tracheal intubation, after endotracheal intubation, after tracheal intubation, at the time of skin incision, at T _ 3s, 0.5 h for one-lung ventilation, 1 h for T _ 5), 1 h for single lung ventilation and 1 h for T _ 5) and at the end of operation. Respiratory index (RI), oxygenation index (OI) and pulmonary blood shunt rate (Qs / QT) were analyzed. TPII index, low frequency power index (LFF) and high frequency power (HFV) were recorded at each time point. HRVV, HRV, SBP, SBP and DBP were recorded. Results the time of operation, the time of single lung ventilation, the volume of transfusion and the amount of blood loss were 0.05 in the two groups. Compared with the control group, the increase of TPI value in the observation group was 0.05% at the time of T4T _ (4) and T _ (5) in the observation group (P < 0.05), and the increase of TPI / QT in the two groups was lower than that in the control group (P < 0.05), and that in the observation group was lower than that in the control group at T _ (6) and T _ (6) (P < 0.05), and that in the observation group was lower than that in the control group (P < 0.05) at the T6 time point (P < 0.05), while in the observation group, it was significantly lower than that in the control group (P < 0.05) at the time point of T _ 6, compared with that in the control group at T _ (0) and T _ (1) T _ (5). Conclusion intravenous injection of dexmetidine can reduce lung injury caused by single lung ventilation in lung cancer patients, improve microcirculation and inhibit the interference of perioperative stimulation on cardiovascular system.
【作者单位】：齐河县人民医院;国家手性制药工程技术研究中心;
【分类号】：R734.2

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