DEX对VTAS肺癌手术患者血流动力学和炎症因子的影响  

Effect of dexmedetomidine on hemodynamics and inflammatory factors of patients with lung cancer during thoracoscopic perioperative period

作　　者：朱波[1] 刘凌[2] 

机构地区：[1]成都市第二人民医院麻醉科,成都610017 [2]成都市第二人民医院疼痛科,成都610017

出　　处：《西南国防医药》2017年第1期6-8,共3页Medical Journal of National Defending Forces in Southwest China

基　　金：成都市卫计委2014年联合攻关科研项目:<罗库溴铵靶控输注用于梗阻性黄疸患者的药代动力学及药效动力学研究>(2014048)

摘　　要：目的观察右美托咪定(DEX)对肺癌患者电视胸腔镜(VTAS)术中血流动力学、炎症因子以及不良反应的影响。方法选择拟行VTAS肺癌手术的患者60例,随机分为DEX组(A组)和对照组(B组),每组30例。A组在麻醉诱导前给予静脉输注DEX负荷剂量0.8μg/kg,持续输注15 min,然后以0.6μg/(kg·h)的速度持续至手术结束前30 min。B组给予等容量的生理盐水。观察两组围手术期血流动力学指标、炎症因子(TNF-α和IL-6)的变化以及不良反应发生情况。结果与B组比较,A组各检测时间点平均动脉压和心率均明显下降,血TNF-α和IL-6表达水平降低(P<0.05);A组术后躁动、寒颤的发生明显少于B组(P<0.05)。结论在VTAS肺癌手术中应用DEX,有利于稳定患者的围术期血流动力学,能够抑制炎症因子的释放,并显著降低围手术期不良反应发生率。Objective To observe the effect of dexmedetomidine on hemodynamics and inflammatory factors of patients with lung cancer during thoracoscopic perioperative period. Methods 60 patients with lung cancer receiving thoracoscopic surgery were selected and divided randomly and equally into DEX group（group A） and control group（group B）. Group A received intravenous infusion of DEX loading dose of（0.8 μg/kg） for 15 min before anesthesia induction, and then to continuous infusion at the rate of0.6 μg/（kg·h） until the end of the operation before 30 min. Group B were given an equal volume of saline as group A. The hemodynamic parameters, changes of inflammatory factors（TNF-α and IL-6）, and incidence of adverse reactions in perioperative period were observed in the two groups. Results Compared with the group B, the me an arterial pressure and heart rate of group A were significantly decreased at each time point, and the expression level of inflammatory factors TNF-α and IL-6 in blood also decreased（P 〈0.05）. The number of postoperative agitation and shivering cases occurred in group A was significantly less than that in group B（P〈 0.05）. Conclusions The application of dexmedetomidine in thoracoscopic surgery for lung cancer can maintain the hemodynamic stability, inhibit the release of inflammatory factors and significantly reduce the incidence of the perioperative adverse reactions.

关 键 词：右美托咪定 肺癌 胸腔镜 血流动力学 炎症因子 不良反应 

分 类 号：R614[医药卫生—麻醉学]