右美托咪定对创伤骨科手术患者氧化应激与炎症反应的影响  

Effect of dexmedetomidine on oxidative stress and inflammatory reaction in patients with orthopaedic trauma surgery

作　　者：冯激波[1] 张磊[2] 吴恙[1] 倪东亮[1] 马安军[1] 马华膺[1] 彭文勇[2] 

机构地区：[1]金华市中心医院骨科,浙江金华321000 [2]金华市中心医院麻醉科

出　　处：《中华全科医学》2017年第6期951-953,共3页Chinese Journal of General Practice

基　　金：浙江省临床科研基金(2012ZYC-A82)

摘　　要：目的探讨右美托咪定对创伤骨科手术患者氧化应激与炎症反应的影响。方法将2015年1月—2016年4月金华市中心医院择期进行手术治疗的创伤骨科患者82例分为研究组(40例)和对照组(42例)。全部患者采用静吸全身复合麻醉。研究组诱导前给予静脉泵注1μg/kg的右美托咪定,并以0.2μg/(kg·h)的剂量维持。对照组给予等量的生理盐水。于入室后(T0)、气管插管结束(T1)、手术60 min时(T2)、手术结束(T3)、拔管时(T4),记录患者心率(HR)、平均动脉压(MAP)水平变化;于T0、T2、T3、术后8 h(T5)、术后24 h(T6)时,对比2组患者超氧化物歧化酶(SOD)、皮质醇、丙二醛、肿瘤坏死因子α(TNF-α)、白介素6(IL-6)水平的变化。结果在T1~T4时,研究组HR、MAP的水平均显著低于对照组,差异有统计学意义(P<0.05);在T3、T5、T6时,研究组SOD显著高于对照组,皮质醇、丙二醛、TNF-α、IL-6显著低于对照组,差异有统计学意义(P<0.05);2组手术时间、术中失血量对比差异无统计学意义(P>0.05);研究组睁眼时间显著低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定能保持创伤骨科手术患者血流动力学稳定,能显著减轻患者氧化应激反应与炎症反应。Objective To investigate the effect of dexmedetomidine on oxidative stress and inflammatory reaction in patients with orthopaedic trauma surgery. Methods Total 82 cases of trauma patients undergoing elective surgery in our hospital between January,2015 and April,2016 were divided into study group（ n = 40） and control group（ n = 42）. All patients received Inhalation-intravenous general anesthesia. The study group was given intravenous infusion of dexmedetomidine 1 μg/kg before the induction and continuous infusion of 0. 2 μg/（ kg · h） dexmedetomidine,while the control group was given the same amount of normal saline. HR and MAP were recorded at T0（ entering the operating room）,T1（ tracheal intubation was over）,T2（ the operation lasted for 60 min）,T3（ the end of the operation） and T4（ extubation）.The levels of SOD,cortisol,MDA,TNF-α and IL-6 at T0,T2,T3,T5（ postoperative 8 h） and T6（ postoperative 24 h） were compared between the two groups. Results At T1-T4,the levels of MAP and HR in the study group were significantly lower than those in the control group and the difference was statistically significant（ P〈0. 05）. At T3,T5 and T6,the level of SOD in the study group was significantly higher than that in the control group,while the levels of cortisol,MDA,TNF-α and IL-6 were significantly lower than those in the control group,the difference was statistically significant（ P〈0. 05）. The operation time and intraoperative blood loss were compared between the two group,the difference was not statistically significant（ P〈0. 05）. The time of awaking from anesthesia in the study group was significantly shorter than that in the control group,the difference was statistically significant（ P〈0. 05）. Conclusion Dexmedetomidine can maintain the stable hemodynamics of patients with orthopaedic trauma surgery,significantly reduce the oxidative stress response and inflammatory reaction of patients.

关 键 词：右美托咪定 创伤骨科 氧化应激反应 炎症反应 

分 类 号：R68[医药卫生—骨科学] R641[医药卫生—外科学]