全麻诱导期右美托咪定+丙泊酚干预对气管插管过程的影响  

Effects of dexmedetomidine + propofol intervention during general anesthesia induction on endotracheal intubation

作　　者：杨懿琳[1] 文婷婷[1] 李秀泽[1] 鲁鸿[1] YANG Yi-lin;WEN Ting-ting;LI Xiu-ze;LU Hong(Department of Anesthesiology,Mianyang Central Hospital in Sichuan Province,Mianyang City,Sichuan Province,621000,P.R.China)

机构地区：[1]四川省绵阳市中心医院麻醉科,四川绵阳621000

出　　处：《海南医学院学报》2018年第9期931-934,共4页Journal of Hainan Medical University

基　　金：四川省绵阳市中心医院院级课题(2015YJ03)~~

摘　　要：目的:探讨全麻诱导期右美托咪定+丙泊酚干预对气管插管过程的影响。方法:选择2017年1~12月间在我院接受气管插管全麻的患者218例,经随机数表法将其分为对照组、右美托咪定组,各109例。对照组患者接受丙泊酚常规麻醉诱导、右美托咪定组患者在丙泊酚基础上加入右美托咪定进行麻醉诱导。对比两组患者全麻诱导后(T0)、气管插管后1min(T1)、气管插管后5min(T2)、气管插管后10min(T3)机体炎症反应、应激反应严重程度差异。结果:T0时,两组患者血清中炎症因子、应激激素含量的差异无统计学意义(P>0.05)。T1、T2、T3时,右美托咪定组患者血清中炎症因子C反应蛋白(CRP)、白介素-1(IL-1)、白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子α(TNF-α)含量低于对照组患者;血清中应激激素促肾上腺皮质激素(ACTH)、皮质醇(Cor)、去甲肾上腺素(NE)、血管紧张素Ⅰ(AngⅠ)、血管紧张素Ⅱ(AngⅡ)含量低于对照组患者。结论:右美托咪定+丙泊酚全麻诱导,可有效减轻气管插管刺激所致机体炎症应激反应。Objective： To investigate the effects of dexmedetomidine ＋ propofol intervention during general anesthesia induction on endotracheal intubation. Methods： A total of 218 patients receiving tracheal intubation general anesthesia in the hospital between January 2017 and December 2017 were divided into the control group （ n =109） and the dexmedetomidine group （ n =109） by random number table method. Control group underwent routine propofol anesthesia induction and dexmedetomidine group underwent dexmedetomidine anesthesia induction on the basis of propofol. The differences in the severity of inflammatory response and stress response were compared between the two groups of patients after general anesthesia induction （T0）, 1 min after endotracheal intubation （T1）, 5 min after endotracheal intubation （T2） and 10 min after endotracheal intubation （T3）. Results： At T0, there was no statistically significant difference in serum levels of inflammatory factors and stress hormones between the two groups. At T1, T2 and T3, serum inflammatory factors CRP, IL-1, IL-6, IL-8 and TNF-α levels of dexmedetomidine group were lower than those of control group; serum stress hormones ACTH, Cor, NE, Ang I and Ang II levels were lower than those of control group. Conclusion： Dexmedetomidine ＋ propofol general anesthesia induction can effectively reduce the inflammatory stress response caused by endotracheal intubation.

关 键 词：气管插管 全麻诱导期 右美托咪定 丙泊酚 

分 类 号：R614[医药卫生—麻醉学]