全麻期间持续应用盐酸右美托咪定对食管癌根治术患者围术期β-EP、TNF-α及IL-6表达水平的影响  

Impact of continuous administration of dexmedetomidine during radical resection of esophageal cancer under general anesthesia on expression level of β-endorphin,TNF-α,IL-6

作　　者：许秋平 

机构地区：[1]湖北省武汉市普仁医院麻醉科,湖北武汉430081

出　　处：《海南医学院学报》2014年第5期663-666,共4页Journal of Hainan Medical University

基　　金：国家自然科学基金(81072840)~~

摘　　要：目的:探讨食管癌根治术患者全麻期间持续给予盐酸右美托咪定后患者血清β-内啡肽(β-EP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平变化。方法:选择我院择期行食管癌根治术的患者63例,随机分为治疗组(盐酸右美托咪定)32例和对照组(氯化钠)31例;对比两组血流动力学水平以及围手术期β-EP、TNF-α、IL-6水平变化。结果:对照组拔管即刻平均动脉压(MAP)、心率(HR)均明显高于麻醉诱导前,且明显高于同时段治疗组水平,组间比较差异具有统计学意义(P<0.05);而治疗组组内各时段MAP、HR比较,差异无统计学意义(P>0.05);在对照组中,拔管即刻、术后1d、术后2d患者血清β-内啡肽水平明显高于麻醉诱导前,拔管即刻、术后1d患者血清TNF-α、IL-6水平明显高于麻醉诱导前(P<0.05);其中对照组麻醉后各时段β-EP、TNF-α、IL-6水平均高于治疗组,两组间相比差异具有统计学意义(P<0.05);而治疗组各时段血清β-EP、TNF-α、IL-6水平比较,差异无统计学意义(P>0.05)。结论:食管癌根治术的患者全麻期间持续给予盐酸右美托咪定能够维持有效缓解手术刺激所致的应激反应,改善患者免疫功能,提高患者术后的预后和转归,值得临床推广。Objective： To explore the impact of continuous administration of dexmedetomidine,during radical resection of esophageal cancer under general anesthesia on expression level of β-endorphin, TNF-α, IL-6. Methods： A total of 63 cases scheduled for radical resection of esophageal cancer patients in were randomly divided into treatment group （dexmedetomidine hydrochloride group, n=32 cases） and the control group （sodium chloride group, n=31 cases） ; compared changes in hemodynamics and beta endorphin, TNF- a, IL-6 levels during peri-operation period. Results. At extubation time, MAP and HR of the control group were significantly higher than that before the induction of anesthesia （P〈0.05）, they ere also significantly higher than those of the treatment group at the same time point （P〈0.05）. For the study group, MAP and HR showed no significant changes during the treatment （P〉0.05）. While for the control group, extubation time, 1 day, 2 days after undergoing the operation, serum 13 - endorphin levels were significantly higher than that before anesthesia induction; at extubation time, 1 day after undergoing the operation, serum TNF-α, and IL-6 levels were significantly higher than those before induction of anes- thesia （P〈0.05）. At all time points, β-EP.TNF-α,IL-6 levels were all significant higher than that of the control group （P〈0.05）. But no significant changes in these levels were observed in the control group （P〉0.05）. Conclusion： During radical resection of esophageal cancer under general anesthesia, continuous administration of dexmedetomidine can relieve stress response and improve patients＇ immune function, thus it can improve prognosis and treatment outcomes.

关 键 词：盐酸右美托咪定 食管癌根治术 Β-内啡肽 肿瘤坏死因子-α 白细胞介素-6 

分 类 号：R735.1[医药卫生—肿瘤]