右美托咪定对肺癌根治术患者单肺通气时的肺保护作用  

Pulmonary protection of dexmedetomidine during one-lung ventilation in patients undergoing radical operation for lung cancer

作　　者：王东昕[1] 阚红莉 于晓东[1] 刘卓 

机构地区：[1]吉林省肿瘤医院麻醉科,长春市130021[2]吉林大学第三医院普外科l30021

出　　处：《中华麻醉学杂志》2014年第6期674-676,共3页Chinese Journal of Anesthesiology

摘　　要：目的评价右美托咪定对肺癌根治术患者单肺通气时的肺保护作用。方法择期拟行肺癌根治术患者30例，性别不限，年龄40-70岁，体重50～80kg，ASA分级I．Ⅲ级。采用随机数字表法，将其分为2组（n：15）：右美托咪定组（D组）和对照组（C组）。D组于麻醉诱导前经10min静脉输注右美托咪定负荷量1．0μg／kg，随后以0．6μg·kg＾-1·h＾-1速率静脉输注至关胸。C组给予等容量生理盐水。于麻醉诱导后即刻（Tl）、单肺通气30min（T2）、60min（T3）、术毕（T4）时分别采集动脉血，采用ELISA法测定血清TNF-a、IL-6及IL-8的浓度，并行动脉血气分析，计算氧合指数。结果与C组比较，D组血清TNF叱IL-6和IL-8浓度降低，氧合指数升高（P〈0．05）。结论右美托咪定可减轻肺癌根治术患者单肺通气期间肺组织炎性反应，改善肺功能，产生肺保护作用。Objective To evaluate the pulmonary protection of dexmedetomidine during one-lung ventilation in patients undergoing radical operation for lung cancer. Methods Thirty patients of both sexes, aged 40-70 yr, weighing 50-80 kg, of ASA physical status Ⅰ-Ⅲ , scheduled for elective radical operation for lung cancer, were randomized into 2 groups （ n = 15 each） ： dexmedetomidine group （ group D） and control group （group C ）. Before induction of anesthesia, a loading dose of dexmedetomidine 1.0 μg/kg was infused over 10 min, followed by continuous infusion of dexmedetomidine at a rate of 0.6μg· kg^- 1· h- 1 until the chest was closed in group D, while the equal volume of normal saline was given in group C. Immediately after induction of anesthesia, at 30 and 60 min of one-lung ventilation, and at the end of operation, arterial blood samples were collected for determination of the serum concentrations of TNF-a, IL-6 and IL-8, and for blood gas analysis. Oxygenation index was calculated. Results Compared with group C, the serum concentrations of TNF-a, IL-6 and IL-8 were significantly decreased, and oxygenation index was increased in group D. Conclusion Dexmedetomidine can mitigate inflammatory responses during one-lung ventilation and improve pulmonary function, thus providing pulmonary protection in patients undergoing radical operation for lung cancer.

关 键 词：右美托咪啶 呼吸 人工 全身炎症反应综合征 呼吸功能试验 

分 类 号：R734.2[医药卫生—肿瘤]