低剂量右美托咪定对腹腔镜卵巢囊肿手术患者围术期炎症因子及应激反应的影响  

Effect of low dose dexmedetomidine on perioperative inflammatory factors and stress response in patients undergoing laparoscopic surgery for ovarian cysts

作　　者：霍苗[1] 张倩[2] 徐瑞芬[1] HUO Miao;ZHANG Qian;XU Ruifen(Department of Anesthesiology,Shanxi People's Hospital,Xi'an 710068,China;Department of Burn and Cosmetic Surgery,Shanxi People's Hospital,Xi'an 710068,China)

机构地区：[1]陕西省人民医院麻醉科,陕西西安710068 [2]陕西省人民医院烧伤美容整形外科,陕西西安710068

出　　处：《西部医学》2019年第5期711-714,718,共5页Medical Journal of West China

基　　金：陕西省社会发展科技攻关项目(2015SF024)

摘　　要：目的探讨低剂量右美托咪定对腹腔镜卵巢囊肿手术患者围术期炎症因子及应激反应的影响。方法选取本院2015年10月～2017年10月期间收治的卵巢囊肿择期行腹腔镜手术患者102例行回顾性分析,根据麻醉用药不同将患者分为Ⅰ组、Ⅱ组和对照组3组,每组各34例。Ⅰ组给予右美托咪定0.4ug/kg·h,Ⅱ组给予右美托咪定0.8ug/kg·h,对照组予以输注等量的0.9%氯化钠注射液。比较3组患者在围术期炎症因子、应激反应及不良反应情况。结果 3组在T_0时血清白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子(TNF-α)水平比较差异无统计学意义(P>0.05);在T_3～T_5时血清IL-6、IL-10、TNF-α水平均升高(P<0.05);3组在气腹后10min(t_1)、术后30min(t_3)时血清促肾上腺皮质激素(ACTH)、抗利尿激素(ADH)、去甲肾上腺素(NA)水平均较前明显升高(P<0.05),Ⅰ、Ⅱ组在相应时间水平低于对照组(P<0.05);3组不良反应总发生率比较差异无统计学意义(P>0.05)。结论腹腔镜卵巢囊肿手术中应用低剂量右美托咪定可改善围术期炎症反应,利于稳定血流动力学,减轻CO_2气腹下手术对患者产生的应激反应,且不增加不良反应发生率,安全性好。Objective To investigate the effect of low dose dexmedetomidine on perioperative inflammatory factors and stress responses in patients undergoing laparoscopic ovarian cysts.Methods A retrospective analysis of 102 patients undergoing laparoscopic surgery for ovarian cysts admitted from October 2015 to October 2017 in our hospital was performed.Patients were divided into 3 groups according to different anesthetic medications,34 cases in each group.Group Ⅰ was given 0.4ug/kg/h dexmedetomidine,group Ⅱ was given 0.8ug/kg/h dexmedetomidine,the control group was a blank control.The perioperative inflammatory factors,stress response and adverse reactions were compared among the 3 groups.Results The levels of serum interleukin-6 (IL-6),interleukin-10 (IL-10) and tumor necrosis factor (TNF-α) in the three groups at T0 were not statistically different ( P >0.05).The serum levels of IL-6,IL-10 and TNF-α increased from T3 to T5 ( P <0.05).The levels of serum adrenocorticotropic hormone (ACTH),antidiuretic hormone (ADH),and norepinephrine (NA) were significantly higher in the three groups at t1~t3 than before ( P <0.05).The levels in group I and II were lower than those of the control group at the corresponding time ( P <0.05).There was no significant difference in the total incidence of adverse reactions between the three groups ( P <0.05).Conclusion Low-dose dexmedetomidine can improve the perioperative inflammatory response in laparoscopic ovarian cysts,which is helpful for stabilizing hemodynamics and reducing the stress response of patients without increasing the adverse reactions rate,and with good safety.

关 键 词：右美托咪定 腹腔镜手术 卵巢囊肿 炎症因子 应激反应 

分 类 号：R723.6[医药卫生—儿科] R971.2[医药卫生—临床医学]