右美托咪定防治下肢手术缺血-再灌注致肺损伤33例临床研究  

Clinical Study on Dexmedetomidine in Preventing Lung Injury Induced by Ischemia-Reperfusion in Lower Limb Surgery in 33 Cases

作　　者：毛武德 崔秀凤 田莲莲 Mao Wude;Cui Xiufeng;Tian Lianlian(Department of Anesthesiology,Jiaozhou Central Hospital,Qingdao,Shandong,China 26630)

机构地区：[1]山东省青岛市胶州中心医院麻醉科,山东青岛266300

出　　处：《中国药业》2018年第20期49-51,共3页China Pharmaceuticals

摘　　要：目的观察右美托咪定防治下肢手术缺血-再灌注所致肺损伤的疗效。方法将66例行下肢全身麻醉手术的患者采用随机双盲法分为观察组与对照组,各33例。采用相同麻醉诱导与麻醉方式,连接呼吸机行机械通气术中分别使用0. 9%氯化钠注射液静脉滴注(对照组)及右美托咪定静脉滴注(观察组)。结果观察组患者止血带松开后白细胞介素6(IL-6)、白细胞介素8(IL-8)、肿瘤坏死因子-α(TNF-α)、血浆丙二醛(MDA)水平均明显低于对照组(P <0. 05),血浆超氧化物歧化酶(SOD)水平明显于对照组(P <0. 05);与麻醉诱导前相比,观察组患者止血带充气后60 min(T_2)、止血带松开后60 min (T3)时点动脉血氧分压(PaO_2)、二氧化碳分压(PaCO_2)、肺泡-动脉氧分压差(A-aDO_2)、呼吸指数(RI)等肺功能指标均无明显变化(P> 0. 05)。结论右美托咪定能有效稳定下肢手术患者各项肺功能指标,改善炎性指标及脂质过氧化反应指标异常,值得临床推广。Objective To observe the effect of dexmedetomidin in preventing lung injury induced by ischemia-reperfusion in lower limb surgery. Methods Totally 66 patients undergoing lower limb general anesthesia surgery were divided into the observation group and the control group by randomized and double-blind method,33 cases in each group. The two groups were given the same anesthesia induction and anesthesia way,and connected the ventilator to mechanical ventilation. During the surgery,the control group was given intravenous drip of 0. 9% Sodium Chloride Injection,the observation group was given intravenous drip of dexmedetomidine. Results The levels of IL-6,IL-8,TNF-α and MDA in the observation group were significantly lower than those in the control group（ P〈0. 05）,while the level of SOD in the observation group was significantly higher than that in the control group（ P〈0. 05）. Compared with before anesthesia induction,there were no significant changes in the pulmonary function indexes such as PaO2,PaCO2,A-aDO2 and RI in the observation group at 60 min after tourniquet inflation（ T2） and 60 min after tourniquet loosening（T3）（ P〉0. 05）. Conclusion Dexmedetomidine can effectively stabilize the pulmonary function of patients undergoing lower limb surgery,improve inflammatory indexes and abnormal lipid peroxidation indexes,which is worthy of clinical promotion.

关 键 词：右美托咪定 下肢手术 肢体缺血-再灌注 肺损伤 

分 类 号：R969.4[医药卫生—药理学] R971.2[医药卫生—药学]