右美托咪定对开胸手术单肺通气患者术中血流动力学和炎性因子的影响  

Effects of Dexmedetomidine on Hemodynamics and Inflammatory Factors during Chest Thoracotomy of Patients with One Lung Ventilation

作　　者：王瑛[1] 郭春燕[1] 陈冬梅[1] 范玲玲[1] 韩志强[1] WANG Ying GUO Chun-yan CHEN Dong-mei FAN Ling-ling HAN Zhi-qiang(Department of anaesthesia, the Att~liated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, 010050, China)

机构地区：[1]内蒙古医科大学附属医院麻醉科,内蒙古呼和浩特010050

出　　处：《现代生物医学进展》2016年第35期6891-6893,6986,共4页Progress in Modern Biomedicine

基　　金：内蒙古自治区科技厅面上项目(2013MS1139)

摘　　要：目的:研究右美托咪定对开胸手术单肺通气患者术中血流动力学和炎性因子的影响。方法:选取我院收治的行开胸手术单肺通气的患者50例,通过随机数表法,平均分为对照组(n=25)和实验组(n=25),对照组采取常规麻醉,实验组在常规麻醉中增加Dex的静脉注射。记录2组平均动脉压的血流动力学指标和心率,对比进入手术时刻(T1),注射右美托咪定15分钟时刻(T2)、气管插管后时刻(T3)、切皮时刻(T4)、单肺通气时刻(T5)和术毕时刻(T6)的生命体征,对比T1、T5、T6、T7的外周血TNF-α、IL-6表达水平。结果:对照组的血流动力学指标在T1和T6时刻与实验组相近,差异无统计学意义(p>0.05);对照组在T2、T3、T4、T5四个时刻显著高于实验组,差异有统计学意义(p<0.05);对照组的TNF-α水平在T1时刻为(33.6±0.7),而实验组为(33.4±0.8),差异无统计学意义(t=0.941,P=0.352);实验组在T5、T6和T7时刻的TNF-α水平均低于对照组,差异有统计学意义(p<0.05);对照组的IL-6水平在T1时刻为(8.7±0.6),而实验组为(8.8±0.6),差异无统计学意义(t=0.589,P=0.558);实验组的IL-6水在T5时刻、T6时刻、T7时刻显著高于实验组,差异有统计学意义(p<0.05)。结论:右美托咪定不仅可以改善术中和术后的血流状况,同时还可以抑制炎症因子,对机体产生保护作用。Objective： To research the effects of dexmedetomidine on hemodynarnics and inflammatory factors during the chest thoracotomy of patients with one lung ventilation. Methods： 50 patients with one lung ventilation who underwent open chest surgery from 2012 to 2015 in our hospital were randomly divided into experimental group （n=25） and control group （n=25）. The control group was given routine anesthesia, while the experimental group was added with Dex intravenous injection to general anesthesia. Recorded the mean arterial pressure of the indexes of hemodynamics and heart rate in the two groups, and compared the life signs at operation time （T1）, 15 minutes after injection of dexmedetomidine （T2）, tracheal intubation time （T3）, cut skin time （T4）, one lung ventilation time （T5） and operation completion time （T6）. Compared the T1, T5, T6, T7, TNF-α, IL-6 expression levels in peripheral blood between the control group and experimental group. Results： The hemodynamic parameters in the control group were similar to that in the experimental group at T1 and T6 time and the difference was not statistically significant （P〉0.05）. The parameters in control group at T2, T3, T4, T5 was significantly higher than that in experimental group and the difference was statistically significant （P〈0.05）. The level of TNF-α at T1 time was （33.6＋ 0.7） in the control group, and （33.4 ±0.8） in the experimental group, having no statistical differences （t=-0.941, P=0.352）. In the experimental group at T5, T6 and T7, the TNF-α level was averagely less than in the control group, and the difference was statistically significant（P〈0.05）. The IL-6 level at T1 time was （8.7＋ 0.6） in the control group, and （8.8± 0.6） in the experimental group, without statistical difference between the two groups（t=-0.589, P=0.558）. The IL-6 level was significantly higher in control group than in experimental group at T5, T6 and T7 moment, and the difference was statistically sig

关 键 词：右美托咪定 开胸手术 单肺通气 炎症因子 

分 类 号：R614[医药卫生—麻醉学] R655[医药卫生—外科学]