右美托咪定对老年食管癌根治术患者氧化应激及血流动力学的影响

发布时间：2018-10-24 20:37

【摘要】：目的探讨右美托咪定对老年食管癌根治术患者氧化应激及血流动力学的影响。方法将90例于该院就诊的老年食管癌患者随机分为观察组和对照组各45例。对照组行常规全麻,并静脉泵入生理盐水,观察组行常规全麻,并静脉泵入右美托咪定。比较两组术前、术后1、7 d氧化应激指标超氧化物歧化酶(SOD)活性及丙二醛(MDA)水平变化,以及诱导前、诱导后10 min、插管时、插管后30 min、拔管后30 min血流动力学指标心率(HR)、平均动脉压(MAP)变化。结果术后1 d,两组患者SOD水平较术前明显降低,MDA水平明显升高,但观察组SOD、MDA水平变化幅度明显更小(均P0.05),术后7 d,两组患者SOD、MDA水平基本恢复,与术前无明显差异(P0.05);两组诱导后10 min、插管后30 min、拔管后30 min HR水平较诱导前均显著下降(P0.05),插管时HR水平较诱导前明显升高(P0.05),其中对照组诱导后10 min、插管后30 min、拔管后30 min HR水平降低、插管时HR水平均较观察组增高明显(P0.05);观察组诱导后10 min、插管时、插管后30 min、拔管后30 min MAP值均较诱导前显著下降(P0.05),但4个时间点MAP值基本处于平稳状态,对照组诱导后10 min、插管后30 min、拔管后30 min MAP值均较诱导前显著下降(P0.05),且明显低于观察组同期,插管时MAP值较诱导前明显增高(P0.05),且明显高于观察组同期(P0.05)。结论右美托咪定可降低老年食管癌根治术患者氧化应激损伤,并且有助于维持麻醉诱导期血流动力学的稳定。
[Abstract]:Objective to investigate the effects of dexmetomidine on oxidative stress and hemodynamics in elderly patients with esophageal cancer undergoing radical resection. Methods 90 elderly patients with esophageal cancer were randomly divided into observation group (n = 45) and control group (n = 45). The control group received routine general anesthesia and intravenous infusion of normal saline, while the observation group received routine general anesthesia and intravenous infusion of dexmetomidine. The changes of superoxide dismutase (SOD) activity and malondialdehyde (MDA) (MDA) were compared between the two groups before and after 1 and 7 days after induction, and before and 10 min, after induction. The mean arterial pressure (MAP) of heart rate (HR) (HR), was changed 30 min after extubation 30 min, after intubation. Results on the 1st day after operation, the SOD level and MDA level in both groups were significantly lower than those before operation, but the SOD,MDA level in the observation group was significantly smaller (P0.05). At 7 days after operation, the SOD,MDA level of the two groups basically recovered. There was no significant difference between the two groups (P0.05), 30 min HR after intubation 30 min, after intubation was significantly lower than that before induction (P0.05), and the HR level was significantly higher at intubation than before induction (P0.05), and 30 min, after 10 min, intubation in the control group (P0.05). The level of 30 min HR after tube was decreased, After intubation, the HR level in the observation group was significantly higher than that in the observation group (P0.05), and in the observation group at 10 min, after intubation, 30 min MAP after intubation was significantly lower than that before intubation (P0.05), but the MAP value was basically stable at 4 time points. The values of 30 min MAP after extubation in the control group were significantly lower than those before induction 10 min, after intubation (P0.05), and significantly lower than those in the observation group (P0.05). The MAP value at intubation was significantly higher than that before induction (P0.05), and was significantly higher than that in the observation group (P0.05). Conclusion dexmetomidine can reduce oxidative stress injury and maintain hemodynamic stability during anesthesia induction in elderly patients with esophageal cancer undergoing radical resection.
【作者单位】：重庆医科大学附属永川医院麻醉科;
【分类号】：R614;R735.1

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