右美托咪定对行肺癌根治术的患者围手术期炎症及肺功能保护作用的影响

发布时间：2018-03-16 08:10

本文选题：肺癌根治术　切入点：右美托咪定　出处：《南方医科大学学报》2017年12期 　论文类型：期刊论文

【摘要】：目的探讨右美托咪定对行肺癌根治术的患者围手术期炎症及肺功能保护作用的影响。方法选取我院2014年5月~2016年5月的124例肺癌根治术患者进行研究,随机分为试验组和对照组各62例,对照组采用单一药物麻醉,试验组在对照组的基础上进行右美托咪定麻醉,比较手术开始前(T_0)、单肺通气(OLV)30 min(T_1)、OLV 60 min(T_2)及手术结束(T_3)2组患者的血清中IL-1β、IL-10以及肿瘤坏死因子(TNF)-α水平变化,采用酶联免疫法(ELISA)测定两组术中肺脏组织标本匀浆中丙二醛(MDA)、髓过氧化物酶(MPO)以及黄嘌呤氧化酶(XOD)水平,观察2组的动脉血氧分压(PaO_2)、氧合指数(OI)、气道平台压(APP)和气道阻力(AR)。结果 2组患者在T_1和T_2时间点IL-1β、IL-10、TNF-α、MDA、MPO、XOD均明显升高,而且试验组的IL-1β、IL-10、TNF-α、MDA水平明显低于对照组,MPO、XOD明显高于对照组,差异具有统计学意义(P0.05);2组患者在T_1和T_2点的PaO_2、OI明显降低,气道平台压和气道阻力明显升高,但是试验组气道平台压和气道阻力明显低于对照组,PaO_2和OI明显高于对照组,差异具有统计学意义(P0.05)。结论肺癌根治术麻醉患者中采用右美托咪定麻醉可以有效的减轻肺部炎症反应,并对患者的肺功起到重要保护作用。
[Abstract]:Objective to investigate the effect of dexmetomidine on perioperative inflammation and pulmonary function protection in patients undergoing radical lung cancer resection. Methods 124 patients undergoing radical resection of lung cancer from May 2014 to May 2016 in our hospital were studied. They were randomly divided into two groups: the experimental group (n = 62) and the control group (n = 62). The control group was anesthetized with a single drug. The serum levels of IL-1 尾 IL-10 and tumor necrosis factor TNF- 伪 were compared before operation and 30 min after operation. The levels of malondialdehyde (MDA), myeloperoxidase (MPO) and xanthine oxidase (XODO) in lung homogenate of both groups were determined by Elisa. The arterial oxygen partial pressure (Pao _ 2), oxygenation index (Oi), airway plateau pressure (AP) and airway resistance were observed in both groups. Results the levels of IL-1 尾 -IL-10TNF- 伪 MDA-MPOXOD in the two groups were significantly higher than those in the control group at T _ 1 and T _ 2 time points, and the level of IL-1 尾 -IL-10TNF- 伪 was significantly lower than that of the control group. The difference was statistically significant (P 0.05). The PaO2OI of the two groups was significantly lower than that of the control group, but the airway plateau pressure and airway resistance in the experimental group were significantly lower than those in the control group. The levels of PaO2 and OI in the experimental group were significantly higher than those in the control group. The difference is statistically significant (P 0.05). Conclusion the use of dexmetomidine anesthesia in patients with lung cancer undergoing radical operation can effectively reduce the inflammatory response of lung and play an important role in protecting lung function.
【作者单位】：广东省人民医院广东省医学科学院麻醉科;广东省心血管病研究所麻醉科;
【基金】：广东省中医药局科研项目(20171004) 广东省科技计划项目(2011B031800149);广东省科技计划项目(2011B031800006)
【分类号】：R614;R734.2

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