右美托咪定预处理对单肺通气后肺损伤的保护作用  

Protection Effect of Pretreatment of Dexmedetomidine on Lung Injury after One-Lung Ventilation

作　　者：陈莹[1] 王德明[1] 吴昆鹏[2] 黄治家[2] 言彩红[2] 

机构地区：[1]南华大学附属第二医院麻醉科,湖南衡阳4210012 [2]南华大学附属第二医院重症医学科

出　　处：《中南医学科学杂志》2016年第3期323-327,共5页Medical Science Journal of Central South China

摘　　要：目的 探讨右美托咪定预先给药对单肺通气后肺损伤的保护作用。方法 选择择期行全麻单肺通气的食管癌病人56例,随机分为右美托咪定组和对照组各28例,分别于麻醉诱导后单肺通气前（T1）、单肺通气6Omin（T2）、120min（T3）、单肺通气结束前（T4）、出室前（T5）及术后24h（T6）时间点记录患者平均动脉压、心率、氧合指数、气道峰压和脑电双频指数值,并测定血清超氧化物歧化酶（SOD）、白介素（IL）-6、丙二醛（MDA）浓度。结果 两组术中监测氧合指数在T2-T4时间点,右美托咪定组低于对照组（P〈0.05）;除T1时间点外,T2-T6时间点血清IL-6、MDA浓度,右美托咪定组明显低于对照组（P〈0.05）,而SOD右美托咪定组明显高于对照组（P〈0.05）;其余指标两组无差异。结论 右美托咪定可显著减低单肺通气期间的炎症因子表达,改善术中的氧合指数,对单肺通气肺损伤有保护作用。Objective To investigate the effects of dexmedetomidine pretreatment on lung injury after one-lung ven- tilation（OLV）. Methods 56 cases of esophageal cancer patients undergoing elective single lung ventilation for general anesthesia ,were randomly divided into two groups of Dexmedetomidine（ Dex group）and control（ NS group） with 28 cases in each group.Mean arterial pressure,heart rate, oxygenation index, airway peak pressure and BIS value were recorded in patients before OLV after anesthesia induction（T1） ,OLV after 60 rain（T2） ,OLV after 120 rain（T3） ,before the end of OLV （T4）, before leaving the operating room（T5） ,and postoperative 24h（T6）.The serum levels of SOD,IL-6 and MDA were measured. Results For intraoperative monitoring oxygenation index in T2 - T4 time points, Dex group is lower than the NS group （P〈0.05） ; IL-6 and MDA in Dex group significantly decreased at time point T2-T6 （P〈0.05） ,SOD in Dex group significantly increased（P〈0.05） ;the rest of the two groups have no difference. Conclusion Dexmedetomidine can significantly decrease inflammatory factor during OLV and improve the technique of oxygenation index, protective lung injury after one lung ventilation.

关 键 词：右美托咪定 单肺通气 肺损伤 

分 类 号：R655.3[医药卫生—外科学]