右美托咪定对妇科腹腔镜手术患者围术期炎症因子及应激反应影响的临床研究  

Effect of dexmedetomidine on perioperative inflammatory factors and stress response in patients with gynecologic laparoscopy

作　　者：孙宏广 龙志鑫 魏喜静 张学琴[1] 李广伟 Sun Hongguang;Long Zhixin;Wei Xijing(Department of Anesthesiology,the Second Hospital of Qinhuangdao,Qinhuangdao 066600)

机构地区：[1]河北省秦皇岛市第二医院麻醉科,秦皇岛066600

出　　处：《陕西医学杂志》2018年第4期494-496,共3页Shaanxi Medical Journal

基　　金：河北省秦皇岛市科学技术局科技计划项目(201602A121)

摘　　要：目的:探讨右美托咪定对妇科腹腔镜手术患者围术期炎症因子及应激反应的影响。方法:将70例择期行妇科腹腔镜手术的患者按随机数字表法分为观察组和对照组,各35例。其中观察组在手术结束前30min静脉缓慢注射右美托咪啶1.0μg/kg(注射时间超过10min)。对照组则于结束前改为生理盐水。分别对两组患者麻醉前、麻醉后1h、术后1d不同时间点的应激反应和炎症反应进行比较。结果:观察组和对照组麻醉前的超氧化物歧化酶(SOD)活性、丙二醛(MDA))评分无统计学意义(P>0.05),两组麻醉后1h和术后1d的MDA和SOD评分明显低于麻醉前(P<0.05),其中以观察组评分最低;观察组麻醉后1h和术后1d的IL-1β、IL-17明显低于对照组(P<0.05),但与其麻醉前的评分无统计学差异(P>0.05),而对照组麻醉1h和术后1d的IL-1β、IL-17与麻醉前比较有统计学意义(P<0.05)。结论:右美托咪定应用于妇科腹腔镜手术中可以更好抑制患者麻醉后应激反应,是一种较为理想的麻醉药物。Objective:To investigate the effect of dexmedetomidin on the perioperative inflammatory factors and stress response in patients with gynecologic laparoscopy.Methods:70 patients who underwent gynecologic laparoscopic surgery were divided into the observation group and the control group according to the random number table,each with 35 cases.In the observation group,right metodetidine was slowly injected into the vein at 30 min before the end of the operation(1 g/kg injection time was over 10 min).The control group was changed into saline before the end.The stress response and inflammatory response of two groups of patients before anaesthesia,1h after anesthesia,and at different time points of 1D after operation were compared.Results:The observation group and the control group of superoxide dismutase before anesthesia(SOD)activity,malondialdehyde(MDA))score was not statistically significant(P>0.05),two groups of 1h after anesthesia and postoperative 1D,MDA and SOD were significantly lower than before anesthesia(P<0.05),the lowest score of the observation group;1D IL-1 P,IL-17 of the observation group after anesthesia and postoperative 1H was significantly lower than the control group(P<0.05),but the score was no significant difference before anesthesia(P>0.05),while the control group 1H anesthesia and postoperative 1D IL-1 IL-17 3,compared with pre anesthesia had statistical significance(P<0.05).Conclusion:Dexmedetomidine should be used in gynecologic laparoscopic surgery to better inhibit the post anaesthesia stress response.It is an ideal anesthetic.

关 键 词：腹腔镜检查 妇科外科手术 麻醉 右美托咪啶 

分 类 号：R713[医药卫生—妇产科学]