不同剂量羟考酮预处理对体外循环心脏手术患者血流动力学及围术期炎性因子的影响

发布时间：2018-11-24 16:55

【摘要】：目的探讨不同剂量羟考酮预处理对体外循环心脏手术患者血液动力学及围术期血清炎性因子的影响。方法选择体外循环下择期心脏瓣膜置换术患者60例,采用随机数字表法分为对照组、羟考酮低剂量组、羟考酮高剂量组,每组20例。羟考酮低、高剂量组麻醉诱导前5 min分别静脉注射0.08、0.12 mg/kg盐酸羟考酮注射液(5 mL),对照组静脉注射等量生理盐水。各组于预处理前(t_1)、体外循环开始即刻(t_2)、体外循环结束(t_3)、手术结束(t_4)、手术后24 h(t_5),检测收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、HR等血流动力学指标及血清TNF-α、IL-6、IL-10等炎性因子指标。结果三组t_2时SBP、DBP、MAP、HR均明显低于t_1(P均0.05)。t_2、t_3时羟考酮低剂量组SBP、DBP、MAP高于羟考酮高剂量组和对照组(P均0.05),且羟考酮高剂量组高于对照组(P均0.05)。各组t_2、t_3、t_4、t_5时血清TNF-α、IL-6、IL-10水平均明显高于t_1(P均0.05)。t_2、t_3、t_4、t_5时,羟考酮低剂量组血清TNF-α、IL-6水平低于羟考酮高剂量组和对照组(P均0.05),血清IL-10水平高于羟考酮高剂量组和对照组(P均0.05);羟考酮高剂量组血清TNF-α、IL-6水平低于对照组(P均0.05),血清IL-10水平高于对照组(P0.05)。结论羟考酮预处理有助于维持体外循环心脏手术患者血流动力稳定,缓解全身炎症状态,且0.08 mg/kg盐酸羟考酮预处理效果更好。
[Abstract]:Objective to investigate the effects of different doses of hydroxycodone pretreatment on hemodynamics and perioperative inflammatory factors in patients undergoing cardiopulmonary bypass (CPB). Methods A total of 60 patients undergoing elective cardiac valve replacement under cardiopulmonary bypass were randomly divided into three groups: control group (n = 20), low dose group (n = 20) and high dose group (n = 20). In the high dose group, 0.08 mg/kg 0.12 mg/kg hydroxycodone hydrochloride injection was injected intravenously 5 min before anesthesia induction (5 mL), control group). Before preconditioning (t _ 1), at the beginning of cardiopulmonary bypass (t _ 2), at the end of cardiopulmonary bypass (t _ 3), at the end of surgery (t _ 4), 24 h after operation (t _ s _ 5), the systolic pressure (SBP),) and diastolic pressure (DBP),) were measured Mean arterial pressure (MAP), HR) and serum TNF- 伪, IL-6,IL-10 and other inflammatory factors. Results SBP,DBP,MAP,HR in the three groups was significantly lower than that in the control group (P < 0. 05), and the SBP,DBP,MAP in the low dose group was higher than that in the high dose group and the control group (both P 0. 05), and that in the low dose group was higher than that in the high dose group and the control group (P < 0. 05). And the high dose group of hydroxycodone was higher than the control group (P 0.05). The levels of serum TNF- 伪 and IL-6,IL-10 in each group were significantly higher than those in tti1 at the time of tipping, and the levels of serum TNF- 伪 and IL-6,IL-10 were significantly higher in each group than in the case of tit _ 2 / t _ 3s / s / s respectively. The levels of serum TNF- 伪 and IL-6 in the low dose group were lower than those in the high dose group and the control group (P 0.05), and the serum IL-10 level was higher than that in the high dose group and the control group (all P 0.05). The levels of serum TNF- 伪 and IL-6 in the high dose group were lower than those in the control group (P 0.05), and the level of serum IL-10 was higher than that in the control group (P0.05). Conclusion hydroxycodone pretreatment is helpful to maintain hemodynamic stability and relieve systemic inflammation in patients undergoing cardiopulmonary bypass (CPB) heart surgery, and 0.08 mg/kg hydroxycodone hydrochloride pretreatment is more effective.
【作者单位】：安徽医科大学附属省立医院;
【分类号】：R654.2

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