依达拉奉对腹腔镜手术病人应激反应的影响  

EFFECTS OF EDARAVONE ON STRESS REACTION IN PATIENTS UNDERGOING LAPAROSCOPIC SURGERY

作　　者：孔欣园 罗友军[1] 栾奇[1] 冀翔宇[1] 闫玮[1] 宋力[1] 

机构地区：[1]青岛大学附属医院麻醉科,山东青岛266003

出　　处：《青岛大学医学院学报》2016年第5期555-557,共3页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：目的了解依达拉奉对腹腔镜直肠癌手术病人应激反应的影响。方法择期行腹腔镜下直肠癌切除手术病人80例,随机分为依达拉奉组（E组）和空白对照组（C组）,各40例。其中E组气管插管后即刻以60.0mg/h流量静脉输注依达拉奉30min,然后以7.5mg/h流量输注至术毕;C组以等容量生理盐水替代依达拉奉。气腹后取头低足高位,分别于气腹前5 min（T1）和气腹后（压力达1.7kPa）30 min（T2）、60 min（T3）、90 min（T4）、120min（T5）以及气腹结束5min（T6）监测血流动力学变化,并采集动脉血行血气分析,采集静脉血测定血浆白细胞介素-6（IL-6）、IL-8水平。结果两组T4、T5平均动脉压（MAP）较T1明显升高（F=39.62、33.88,P〈0.05）。两组T5、T6乳酸浓度均较T1明显上升（F=99.88、45.85,P〈0.05）,两组间T5、T6时比较差异有统计学意义（t=3.14、3.75,P〈0.05）。两组T4、T5、T6时血糖与T1比较明显升高（F=97.61、49.52,P〈0.05）,两组间T5、T6时血糖比较差异有显著性（t=8.59、9.67,P〈0.05）。两组T2、T3、T4、T5、T6时IL-6、IL-8与T1比较明显升高（F=36.86-111.36,P〈0.05）,两组间T6时IL-6、IL-8比较差异有显著性（t=8.23、8.02,P〈0.05）。结论依达拉奉能够抑制CO2气腹刺激引起的机体应激反应,抑制血糖和血乳酸的升高,其机制可能与抗炎性递质生成有关。Objective To investigate the effects of edaravone on stress reaction in patients undergoing laparoscopic surgery. Methods Eighty patients scheduled for laparoscopic resection of rectal cancer were equally divided into edaravone group（group E）and control group（group C）in random.After tracheal intubation,the patients in group E were immediately given intravenous infusion of edaravone 60.0mg/h for 30 min,and then at 7.5mg/h until the end of operation.For those in group C,an equal volume normal saline was infused instead of edaravone.After pneumoperitoneum（PP,intra-abdominal pressure=1.7kPa）,the patients were placed on Trendelenburg position.At 5min before PP（T1）,and at 30,60,90 and 120min（T2-5）of PP and at the end of PP（T6）,the changes of hemodynamics were monitored.Arterial blood was collected for blood gas analysis,and venous blood for detecting IL-6and IL-8. Results The mean arterial pressure（MAP）at T4 and T5of both groups was higher than that at T1（F=39.62,33.88;P〈0.05）.The concentration of lactic acid at T5 and T6of both groups notably elevated versus T1（F=99.88,45.85;P〈0.05）,and the difference in T5 and T6between the two groups was statistically significant（t=3.14,3.75;P〈0.05）.The levels of blood sugar at T4,T5 and T6were higher than that at T1（F=97.61,49.52;P〈0.05）,the differences of blood sugar levels at T5 and T6between the two groups were significant（t=8.59,9.67;P〈0.05）.The levels of IL-6and IL-8at T2,T3,T4,T5 and T6of both groups were higher than that at T1（F=36.86-111.36,P〈0.05）,and at T6 the differences in IL-6and IL-8levels between the two groups were significant（t=8.23,8.02;P〈0.05）. Conclusion Edaravone can inhibit physical stress reaction caused by stimulus of CO2 pneumoperitoneum and restrain the elevation of blood sugar and blood lactic acid,its mechanism might be related to the production of anti-inflammatory neurotransmitter.

关 键 词：依达拉奉 直肠肿瘤 腹腔镜检查 应激 生理学 

分 类 号：R614[医药卫生—麻醉学]