不同剂量右美托咪啶对单肺通气患者围术期炎性反应的影响  

Effects of different doses of dexmedetomidine on perioperative inflammatory response in patients undergoing one lung ventilation

作　　者：张荣智[1] 石翊飒[1] 张亚敏[2] 刘志龙[1] 谢建琴[1] 王书宝[1] 徐旭[1] 

机构地区：[1]兰州大学第二医院麻醉科,730030 [2]兰州大学第二医院血管科,730030

出　　处：《中华麻醉学杂志》2011年第12期1443-1445,共3页Chinese Journal of Anesthesiology

基　　金：甘肃省技术研究与开发专项计划（1105TCYA001）

摘　　要：目的探讨不同剂量右美托咪啶对单肺通气患者围术期炎性反应的影响。方法择期行食管癌根治术患者36例，ASA分级Ⅰ或Ⅱ级，性别不限，年龄43～72岁，体重50～78kg，采用随机数字表法，将其随机分为3组（n=12）：对照组（C组）、低剂量右美托咪啶组（D．组）和高剂量右美托咪啶组（D2组）。麻醉诱导前，D．组和D：组经10min静脉输注右美托咪啶1μg／kg，随后分别以0．2和0．5μg·kg^-1·h^-1的速率输注至术毕前30min，C组采用同样方法静脉输注等容量生理盐水。于麻醉诱导前（L）、单肺通气前即刻（L）、单肺通气30min（R）、90min（T1）、膨肺后30min（T4）和术后2h（L）时采集静脉血样，测定血清TNF—a、IL-8浓度。结果与R时比较，三组L～T5时血清TNF—a、IL-8浓度升高（P〈0．05）；与c组比较，D，组B～L时血清TNF—d、IL-8浓度降低（P〈0．05），D．组上述指标差异无统计学意义（P〉0．05）。结论麻醉诱导前给予右美托咪啶1μg／kg，术中以0．5μg·kg^-1·h^-1的速率输注可明显降低单肺通气患者围术期的炎性反应。Objective To investigate the effects of different doses of dexmedetomidine on perioperative in- flammatory response in patients undergoing one lung ventilation （OLV） . Methods Thirty-six ASA Ⅰ or Ⅱ patients aged 43-72 yr weighing 50-78 kg scheduled for esophagectomy were randomly divided into 3 groups （ n = 12 each）： control group （group C）, low dose dexmedetomidine group（group D1）and high dose dexmedetomidine group （group D2 ）. Dexmedetomidine 1 μg/kg was infused iv over 10 min before anesthesia induction, and then was infused at a rate of 0.2μg·kg^-1·h^-1 （ group D1） or 0.5μg·kg^-1·h^-1（ group D2 ） until 30 min before the end of operation. Group C received the equal volume of normal saline. Blood samples were collected before anesthesia induction （T0）, immediately before OLV （T1） ,at 30 min （T2 ） and 90 min （T3 ） of OLV, at 30 min after lung in- flate （T4） and at 2 h after operation （T5 ） for determination of serum TNF-a and IL-6 concentrations. Results Compared with To, serum TNF-a and IL-6 concentrations were significantly increased at T3-T5 in the 3 groups （P 〈 0.05）. Compared with group C, serum TNF-a and IL-6 concentrations were significantly decreased at T3-T5 in group D2 （P 〈 0.05）. There was no significant difference in the indexes mentioned above between group C and group D1 （ P 〉 0.05） . Conclusion Dexmedetomidine 1 μg/kg given before induction and then infused at a rate of 0.5μg·kg^-1·h^-1 druing operation can reduce inflammatory response in patients undergoing OLV.

关 键 词：右美托咪啶 呼吸 人工 炎症 

分 类 号：R614[医药卫生—麻醉学]