右美托咪定超前镇痛对体外循环下行心脏瓣膜置换术患者肺炎性反应的影响

发布时间：2018-04-22 08:46

本文选题：麻醉 + 右美托咪定　；参考：《山东医药》2017年28期

【摘要】：目的探讨右美托咪定超前镇痛对体外循环下行心脏瓣膜置换术患者肺炎性反应的影响。方法选择体外循环下行心脏瓣膜置换术患者80例,随机分为观察组和对照组各40例,观察组在麻醉诱导前30 min静脉泵注1.0μg/kg右美托咪定麻醉诱导15 min,以0.5μg/(kg·h)右美托咪定进行麻醉维持,直至手术结束。记录两组术后清醒时间、自主呼吸恢复时间、定向力恢复时间。两组分别于体外循环心脏复跳5、30、60 min取肺静脉血,采用流式细胞仪计数中性粒细胞(PMN)、CD11b~+细胞,采用ELISA法检测血清IL-8、IL-10。结果观察组术后清醒时间、自主呼吸恢复时间、定向力恢复时间均较对照组缩短(P均0.05)。观察组体外循环心脏复跳5、30、60 min肺静脉PMN、CD11b~+数量及血清IL-8水平均较对照组降低,血清IL-10水平均较对照组升高(P均0.01)。结论右美托咪定可抑制体外循环下行心脏瓣膜置换术患者肺炎性反应,有利于麻醉后恢复。
[Abstract]:Objective to investigate the effect of dexmetidine preemptive analgesia on pneumonic response of patients undergoing cardiac valve replacement under cardiopulmonary bypass. Methods 80 patients undergoing cardiac valve replacement under cardiopulmonary bypass were randomly divided into two groups: the observation group (n = 40) and the control group (n = 40). In the observation group, intravenous infusion of 1. 0 渭 g/kg dexmetomidine was administered 30 min before anesthesia induction for 15 minutes, followed by 0.5 渭 g/(kg / h) dexmetidine for maintenance until the end of the operation. The recovery time of spontaneous respiration and directional force were recorded. The pulmonary venous blood was collected at 60 min after cardiopulmonary bypass (CPB). The neutrophil PMNs CD11b~ cells were counted by flow cytometry, and the serum IL-8 IL-10 was detected by ELISA method. Results the recovery time of spontaneous respiration, recovery of spontaneous respiration and recovery of directional force in the observation group were significantly shorter than those in the control group (P < 0.05). Compared with the control group, the number of CD11b~ and the level of serum IL-8 in the observation group were lower than those in the control group, and the levels of serum IL-10 were higher than those of the control group (P < 0.01). Conclusion dexmetomidine can inhibit pneumonic response of patients undergoing cardiac valve replacement under cardiopulmonary bypass and is beneficial to recovery after anesthesia.
【作者单位】：河北北方学院附属第一医院;张家口市沙岭子医院;
【基金】：河北省科技厅重点项目(162777173) 河北省张家口市科技指导性项目(1621075D)
【分类号】：R654.2

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