右美托咪定复合臂丛神经阻滞对上肢骨折患者血清VEGF的影响  

Impact of dexmedetomidine combined with brachial plexus nerve block on serum VEGF of upper limb fracture patients

作　　者：范东毅[1] 

机构地区：[1]中山大学附属第五医院麻醉科,519000

出　　处：《中国实用医药》2017年第16期16-18,共3页China Practical Medicine

摘　　要：目的研究右美托咪定(Dex)复合臂丛神经阻滞对上肢骨折内固定手术患者围术期血清血管内皮细胞生长因子(VEGF)水平的影响。方法 60例[美国麻醉医师协会(ASA)Ⅰ~Ⅱ级]择期行上肢骨折内固定手术患者,随机分成A、B两组,每组30例。A组为单纯臂丛神经阻滞,B组为右美托咪定复合臂丛神经阻滞。分别于T0~T5时点抽血5 ml,测定血清VEGF的浓度。结果 B组麻醉完成时(T1)、手术开始后30 min(T2)、术毕即刻(T3)时点的平均动脉压(MAP)和心率(HR)均低于麻醉前(T0),差异有统计学意义(P<0.05);B组T1、T2、T3时点的MAP和HR均低于A组,差异有统计学意义(P<0.05)。两组患者各时点血氧饱和度(Sp O2)比较差异无统计学意义(P>0.05)。两组T1、T2、T3、术后6 h(T4)及术后24 h(T5)时点的VEGF浓度均高于T0,差异有统计学意义(P<0.05);B组T1~T5时点的VEGF浓度分别为(182.6±38.6)、(195.3±33.7)、(234.1±42.4)、(288.2±37.5)、(318.3±38.8)pg/ml,高于A组的(171.6±40.5)、(176.3±41.2)、(206.2±36.8)、(234.1±33.3)、(266.2±36.2)pg/ml,差异有统计学意义(P<0.05)。结论右美托咪定复合臂丛神经阻滞能促进VEGF的分泌,更有利于上肢骨折患者的术后愈合。Objective To study the impact of dexmedetomidine（Dex） combined with brachial plexus nerve block on serum vascular endothelial growth factor（VEGF） level of upper limb fracture internal fixation patients in perioperative period. Results A total of 60 patients with selective upper limb fracture internal fixation surgery [American Society of Anesthesiologists（ASA） grade Ⅰ - Ⅱ ] were randomly divided into group A and group B, with 30 cases in each group. Group A received only brachial plexus nerve block, and group B received dexmedetomidine combined with brachial plexus nerve block. 5 ml blood was collected respectively at T0-T5 time points to test concentration of serum VEGF. Results Group B had lower mean arterial pressure（MAP） and heart rate（HR）, at the end of anesthesia（T1）, 30 min after operation beginning（T2） and instantly completed operation（T3） than before anesthesia（T0）, and their difference had statistical significance（P〈0.05）. Group B had lower MAP and HR at T1, T2 and T3 than group A, and the difference had statistical significance（P〈0.05）. Both groups had no statistically significant difference in saturation of blood oxygen（SpO2） at all time points（P〉0.05）. Both groups had higher VEGF concentration at T1, T2, T3, postoperative 6 h（T4） and postoperative 24 h（T5） than T0, and their difference had statistical significance（P〈0.05）. Group B had VEGF concentration at T1-T5 respectively as（182.6±38.6）,（195.3±33.7）,（234.1±42.4）,（288.2±37.5） and（318.3±38.8） pg/ml, which were all higher than（171.6±40.5）,（176.3±41.2）,（206.2±36.8）,（234.1±33.3） and（266.2±36.2） pg/ml in group A, and their difference had statistical significance（P〈0.05）. Conclusion Combination of dexmedetomidine and brachial plexus nerve block can promote secretion of VEGF, and it is more conductive to postoperative healing of upper limb fracture patients.

关 键 词：右美托咪定 臂丛神经阻滞 骨折愈合 血管内皮细胞生长因子 

分 类 号：R614[医药卫生—麻醉学]