右美托咪定对腹腔镜直肠癌根治术患者血清炎性因子水平及肺功能的影响  

Effect of Dexmedetomidine on Serum Inflammatory Factor Levels and Pulmonary Function in Patients with Laparoscopic Radical Resection of Rectal Cancer

作　　者：蔡浩亮 王兰[1] 陈曦[1] 郭丰[1] CAI Hao-liang;WANG Lan;CHEN Xi(Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200126,China)

机构地区：[1]上海中医药大学附属曙光医院麻醉科,上海200126

出　　处：《医学临床研究》2019年第10期1939-1941,共3页Journal of Clinical Research

摘　　要：【目的】探讨右美托咪定(Dex)对腹腔镜直肠癌根治术患者血清炎性因子水平及肺功能的影响。【方法】100例腹腔镜直肠癌根治术患者,其中采用常规麻醉的54例患者设为对照组,46例在常规麻醉基础上静脉持续泵入盐酸Dex的患者设为观察组。比较两组麻醉诱导前(T0)、人工气腹建立时(T1)、手术结束时(T2)的呼吸频率(RR)、心率(HR)、平均动脉压(MAP)、中心静脉压(CVP),血清炎性因子水平[C-反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平,肺功能参数[气道阻力(Raw)、最大通气量(MVV)、第一秒用力呼气容积(FEV1)、肺动态顺应性(Cdyn)]。【结果】两组T0时各项指标比较差异均无显著性(P>0.05);对照组T1、T2的RR、HR、MAP、CVP均显著高于观察组(P<0.05)。对照组术后24 h的CRP、IL-6、TNF-α均显著高于观察组(P<0.05)。对照组术后24 h的MVV、FEV1、Cdyn均显著低于,Raw显著高于观察组(P<0.01)。【结论】Dex可显著降低腹腔镜直肠癌根治术患者的血清炎性因子水平,稳定其心率、呼吸及血流动力学,从而提高患者的肺功能,促进临床疗效。【Objective】To investigate the effect of dexmedetomidine(Dex)on serum inflammatory factor levels and pulmonary function in patients with laparoscopic radical resection of rectal cancer.【Methods】A total of 100 patients with laparoscopic radical resection of rectal cancer were enrolled in the study.The control group contained 54 patients undergoing conventional anesthesia for the surgery,and the observation group included 46 patients with continuous intravenous infusion of Dex hydrochloride on the basis of conventional anesthesia.The respiratory rate(RR),heart rate(HR),mean arterial pressure(MAP),central venous pressure(CVP),serum inflammatory factor levels(CRP,IL-6,TNF-α)and lung function parameters(Raw,MVV,FEV1,Cdyn)before the induction of anesthesia(T0),the establishment of artificial pneumoperitoneum(T1),the end of surgery(T2)were measured and compared between the two groups.【Results】There were no significant differences in terms of the above indexes at T0 between the two groups(P>0.05).The RR,HR,MAP and CVP of T1 and T2 in the control group were significantly higher than those the observation group(P<0.05).The CRP,IL-6 and TNF-α levels in the control group were significantly higher than those in the observation group at 24h after operation(P<0.05).The MVV,FEV1 and Cdyn of the control group were significantly lower,while Raw was significantly higher than that of the observation group at 24 hours after surgery(P<0.01).【Conclusion】Dex can significantly reduce serum inflammatory factor levels in patients undergoing laparoscopic radical resection,stabilize heart rate,respiration and hemodynamics,thereby improving lung function and promoting clinical outcomes.

关 键 词：直肠肿瘤/外科学 腹腔镜检查 右美托咪定/治疗应用 

分 类 号：R735.37[医药卫生—肿瘤]