右美托咪定改善合并中度慢性阻塞性肺疾病肺癌手术患者的肺氧合功能  

Dexmedetomidine improves function of lung oxygenation in patients with moderate chronic obstructive pulmonary disease underwent lung cancer surgery

作　　者：张继如[1,2] 董楠[2] 钱红娣[2] 俞卫锋[3,4] 

机构地区：[1]苏州大学临床医学院,江苏苏州215006 [2]江南大学附属医院(无锡市第四人民医院)麻醉科,江苏无锡214062 [3]第二军医大学附属东方肝胆外科医院 [4]上海交通大学附属仁济医院麻醉科,上海200438

出　　处：《中南大学学报（医学版）》2017年第3期271-276,共6页Journal of Central South University ：Medical Science

基　　金：无锡市卫生和计划生育委员会基金(MS201517);无锡市医院管理中心课题(YGZXY1307)~~

摘　　要：目的:探索右美托咪定是否能改善合并中度慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)肺癌手术患者肺氧合作用和肺呼吸力学参数。方法:将56名合并有中度COPD的肺癌手术患者随机分配到对照组或Dex组(每组n=28)。单肺通气期间,Dex组右美托咪定初始负荷剂量为1.0μg/kg,微量泵注10 min,随后维持剂量改为0.5μg/kg,持续泵注1 h。对照组采用同样方法给予相同容量的0.9%生理盐水。结果:Dex组的氧合指数明显高于对照组(P<0.05),在Dex-30和Dex-60时肺动态顺应性明显增加(P<0.05)。Dex组的术后氧合指数显著升高(P=0.025),术后并发症明显减少。结论:对合并有中度COPD的肺癌手术患者,右美托咪定能够提高肺氧合指数,改善肺呼吸力学参数和减少术后肺部并发症。Objective： To determine whether dexmedetomidine（Dex） improves oxygenation and lung mechanics in patients with moderate chronic obstructive pulmonary disease（COPD） during lung cancer surgery. Methods： Fifty-six patients with moderate COPD were randomly allocated to a control group and a Dex group（n=28 each）. In the Dex group, dexmedetomidine was given as an initial loading dose at 1.0 μg/kg lasting for 10 min followed by a maintenance dose at 0.5 μg/（kg.h） during OLV while the control group was administered an equal volume of 0.9% saline accordingly. Results： Patients in the Dex group had a significantly higher oxygenation index（P〈0.05） and higher dynamic lung compliance at Dex-30 and Dex-60（P〈0.05） compared with those in the control group. In the Dex group, oxygenation index in the postoperative period was significantly higher（P= 0.025） and postoperative complications were lower than those in the control group. Conclusion： Dex administration may provide clinically relevant benefits by improving o xygenation index and lung mechanics, and reducing postoperative pulmonary complications in patients with moderate COPD underwent lung cancer surgery.

关 键 词：右美托咪定 单肺通气 氧合指数 呼吸力学 

分 类 号：R614[医药卫生—麻醉学]