右美托咪定辅助静吸复合麻醉对进展期胃癌患者术后机体氧化损伤及血清Thl/Th2、皮质醇水平的影响  

Effects of Dexmedetomidine combined with intravenous inhalation compond anesthesia on oxidative damage and serum levels of Thl/Th2 and Cor in patients with advanced gastric cancer

作　　者：程蕾 涂小磊 CHENG Lei;TU Xiao-lei(Department of Anesthesia,Xiaogan Central Hospital,Xiaogan Hubei 432100,China)

机构地区：[1]孝感市中心医院麻醉科,湖北孝感432100

出　　处：《临床和实验医学杂志》2019年第2期215-219,共5页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨右美托咪定辅助静吸复合麻醉对进展期胃癌患者术后机体氧化损伤及血清Thl/Th2、皮质醇(Cor)水平变化的影响。方法前瞻性选取2015年4月至2017年7月孝感市中心医院74例进展期胃癌患者,随机数字表法分为对照组(n=37)与研究组(n=37)。对照组采取静吸复合麻醉,研究组采取右美托咪定辅助静吸复合麻醉。分别于不同时间段[麻醉诱导前(T0)、手术开始后30 min(T1)、术后30 min(T2)]对比两组皮质醇(Cor)、氧化损伤指标[超氧化物歧化酶(SOD)、还原型谷胱甘肽(GSH)、丙二醛(MDA)]、Thl/Th2指标[干扰素-γ(IFN-γ)、白细胞介素-4(IL-4)、IFN-γ/IL-4]水平、七氟醚吸入浓度及不良反应发生率。结果 T1、T2时期两组血清Cor水平较T0时期增高,但研究组较对照组低(P <0. 05);术后两组血清SOD、GSH水平较术前降低,MDA水平较术前增高,但研究组血清SOD、GSH水平较对照组高,MDA水平较对照组低(P <0. 05);术后两组血清IFN-γ、IFN-γ/IL-4较术前增高,IL-4较术前降低,且研究组IFN-γ、IFN-γ/IL-4较对照组高,IL-4较对照组低(P <0. 05); T0时期两组七氟醚吸入浓度比较,差异无统计学意义(P> 0. 05),T1、T2时期研究组七氟醚吸入浓度较对照组低(P <0. 05);研究组不良反应发生率(10. 81%)较对照组(29. 73%)低(P <0. 05)。结论右美托咪定辅助静吸复合麻醉利于减轻应激反应及氧化损伤程度,降低七氟醚吸入浓度,并改善术后免疫抑制状态,利于机体免疫功能恢复,减少不良反应。Objective To investigate the effects of dexmedetomidine combined with intravenous inhalation compond anesthesia on oxidative damage and serum levels of Th1/Th2 and cortisol(Cor)in patients with advanced gastric cancer.Methods 74 patients with advanced gastric cancer in our hospital from April 2015 to July 2017 were randomly divided into the control group(n=37)and the study group(n=37).The control group received intravenous inhalation compond anesthesia,and the study group received intravenous inhalation compond anesthesia assisted by dexmedetomidine.In different period of time[before the induction of anesthesia(T0),30 min after the start of operation(T1),30 min after operation(T2)],cortisol(Cor),oxidative damage index[superoxide dismutase(SOD),glutathione(GSH),malondialdehyde(MDA)],Th1/Th2 index[interferonγ(IFN-γ),interleukin-4(IL-4),IFN-γ/IL-4]level,sevoflurane concentration and the incidence of adverse reactions between two groups were compared.Results The serum Cor levels of the two groups in the T1 and T2 periods were higher than those in the T0 phase,but the study group was lower than the control group(P<0.05).The levels of serum SOD and GSH in the two groups were lower than those before the operation,and the level of MDA was higher than that before the operation,but the serum levels of SOD and GSH in the study group were higher than those of the control group,and the level of MDA was lower than that of the control group(P<0.05).The levels of serum IFN-γ,IFN-γand/IL-4 in the two groups were higher than those before operation,and IL-4 was lower than that before the operation,and the levels of IFN-γ,IFN-γand/IL-4 of the study group were higher than that of the control group,and IL-4 was lower than that of the control group(P<0.05).There was insignificant difference in the inhaled concentration of sevoflurane between the two groups in T0 period(P>0.05).The inhalation concentration of sevoflurane in the study group was lower than that in the control group during the period of T1 and T2(P<0.05).The inciden

关 键 词：进展期胃癌 右美托咪定 静吸复合麻醉 氧化损伤 TH1/TH2 皮质醇 

分 类 号：R614[医药卫生—麻醉学] R735.2[医药卫生—外科学]