术中持续泵注右美托咪定对全麻手术患者围术期应激、炎症的影响:Meta分析  

Effects of continuous intraoperative infusion of dexmedetomidine on perioperative stress and inflammation in patients undergoing general anesthesia:A Meta-analysis

作　　者：吴梦鸽 徐健 吴长帅 张宝慧 王坤[1] WU Mengge;XU Jian;WU Changshuai;ZHANG Baohui;WANG Kun(Department of Anesthesiology,Harbin Medical University Cancer Hospital,Heilongjiang Harbin 150000,China)

机构地区：[1]哈尔滨医科大学附属肿瘤医院麻醉科,黑龙江哈尔滨150000

出　　处：《现代肿瘤医学》2021年第2期315-322,共8页Journal of Modern Oncology

摘　　要：目的:通过Meta分析比较右美托咪定(dexmedetomidine,DEX)对手术患者围术期炎症和应激反应的影响。方法:我们分别检索了PubMed,METSTR,EMBASE和Web of Science四个数据库,共收录30篇评估术中持续泵注DEX对全麻手术患者围术期炎症和应激反应影响的随机对照实验。结局指标包括肾上腺素、去甲肾上腺素、皮质醇、血糖、IL-6、TNF-α、CRP、IL-10、IL-1β和WBC水平。连续性变量采用标准均数差(standard mean difference,SMD)和95%置信区间(CI)作为合并统计量。结果:Meta分析结果显示,与对照组相比,DEX组肾上腺素、去甲肾上腺素、皮质醇、血糖、IL-6、TNF-α、IL-1β、WBC水平降低,且差异有统计学意义。CRP、IL-10水平在两组无统计学差异。结论:DEX作为一种麻醉辅助药,能显著降低全麻手术患者应激(肾上腺素、去甲肾上腺素、血浆皮质醇、血糖)和炎症(IL-6、TNF-α和IL-1β)反应水平,有助于改善患者的临床疗效。但CRP、IL-10水平在两组无统计学差异。Objective:To review the effects of perioperative intravenous injection of dexmedetomidine on inflammation and stress response in patients undergoing general anesthesia with meta-analysis approach.Methods:We searched five databases with PubMed,EMBASE,MEDLINE,and Web of Science.A total of 30 randomized controlled trials were collected to evaluate the effects of perioperative intraoperative intravenous infusion of dexmedetomidine on inflammatory and stress responses in patients undergoing general anesthesia.Outcomes included the level of epinephrine,norepinephrine,cortisol,blood glucose,IL-6,TNF-α,CRP,IL-10,IL-1βand WBC.Standard mean difference(SMD)and 95%confidence intervals(CI)were used as combined statistics for continuous outcomes.Results:Dexmedetomidine infusion during anaesthesia inhibited the release of epinephrine,norepinephrine,cortisol,and decreased blood glucose,IL-6,TNF-α,IL-1βand WBC of surgical patients.There was no significant difference in the level of CRP and IL-10.Conclusion:As an anesthetic adjuvant,dexmetomidine can significantly reduce perioperative stress(epinephrine,norepinephrine,plasma cortisol,blood glucose)and inflammation(IL-6,TNF-α,IL-1βand WBC)response,helping to improve the clinical efficacy of patients.But there was no significant difference in the level of CRP and IL-10.

关 键 词：右美托咪定(DEX) 应激 炎症 手术患者 META分析 

分 类 号：R730.7[医药卫生—肿瘤]