右美托咪定对胸腔镜食管癌根治术患者血清炎性因子的影响  

Effect of dexmedetomidine on the serum inflammatory cytokines in patients undergoing thoracoscopic radical resection of esophageal carcinoma

作　　者：万亮[1] 王小锐[1] 郭文艳[1] 董玥颖 WAN Liang;WANG Xiao- rui;GUO Wen-yan;DONG Yue-ying(Department of Anesthesiology, the Second Hospital of Tangshan, Tangshan 063000, China)

机构地区：[1]唐山市第二医院麻醉科,河北唐山063000

出　　处：《实用药物与临床》2019年第2期134-136,共3页Practical Pharmacy and Clinical Remedies

基　　金：河北省2015年度医学科学研究重点课题计划(20150929)

摘　　要：目的探讨右美托咪定(Dex)对胸腔镜食管癌(EC)根治术患者血清炎性因子的影响。方法选择2016年1月至2017年11月我院在胸腔镜下行EC根治术的58例患者为研究对象,随机分为观察组和对照组,每组29例。两组患者麻醉诱导后纤维支气管镜定位行双腔管气管插管,单肺控制呼吸。观察组泵入Dex 1μg/kg,对照组泵入生理盐水0. 5 ml/kg,术后给予自控镇痛泵。在麻醉诱导前(T_0)、手术结束时(T_1)、术后24 h (T_2)、术后72 h (T_3)测量患者平均动脉压(MAP)、心率(HR),采集颈内静脉血标本,采用酶联免疫吸附法(ELISA)检测炎性因子白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)。结果在T_1时,观察组患者M AP、HR低于对照组(P <0. 05),T_1～T_3时,观察组血清TNF-α、IL-1β、IL-6低于对照组(P <0. 05)。结论 Dex能够有效改善胸腔镜EC根治术患者围术期炎症反应,维持围术期血流动力学稳定。Objective To explore the effect of dexmedetomidine(Dex)on serum inflammatory cytokines in patients undergiong thoracoscopic radical resection of esophageal carcinoma(EC).Methods A total of 58 patients with esophageal carcinoma(EC)in our hospital from January 2016 to November 2017 receiving thoracoscopic radical resection of EC were included in the study and randomized into observation group and control group,29 cases in each group.After anesthesia induction,the double-lumen tube tracheal intubation was performed under the location of fiber bronchoscope.Respiration was controlled by single lung.Patients in observation group were given 1μg/kg Dex,while the patients in control group were given 0.5 ml/kg normal saline.Patients were given patient-controlled analgesia pump after operation.The levels of MAP and HR were measured before anesthesia induction(T0)and at 0 h,24 h and 72 h after operation(T1,T2 and T3),and the internal jugular venous blood was collected at the same time.The levels of IL-1β,IL-6 and TNF-α were detected by ELISA.Results The levels of MAP and HR in observation group were lower than those in control group at T1(P<0.05),and the levels of serum IL-1β,IL-6,and TNF-α in observation group were lower than those in control group at T1,T2 and T3(P<0.05).Conclusion Dex can effectively improve the perioperative inflammatory reaction in patients undergoing thoracoscopic radical resection of EC,and maintain the stability of perioperative hemodynamics.

关 键 词：右美托咪定 胸腔镜 食管癌根治术 炎性因子 

分 类 号：R614[医药卫生—麻醉学] R735.1[医药卫生—外科学]