右美托咪定复合腰硬联合麻醉在TURP术中应用对患者炎症应激反应、呼吸功能的影响  

Effects of Dexmedetomidine Combined with Spinal Epidural Anesthesia on Inflammatory Stress Response and Respiratory Function in Patients Undergoing TURP

作　　者：辛志祥[1] 董翔[1] 林宇[1] XIN Zhi-xiang;DONG Xiang;LIN Yu(Department of Anesthesiology,The Ninth People's Hospital,Shanghai Jiaotong University School of Medicine Shanghai 201900)

机构地区：[1]上海交通大学医学院附属第九人民医院麻醉科,上海201900

出　　处：《医学临床研究》2020年第12期1802-1804,1807,共4页Journal of Clinical Research

基　　金：上海市科学技术委员会科研计划项目(12401903204)。

摘　　要：【目的】探讨右美托咪定(Dex)复合腰硬联合麻醉在经尿道前列腺电切术(TURP)中应用对患者炎症应激及呼吸功能的影响。【方法】本院拟行TURP手术治疗的100例患者,随机分为两组,各50例;观察组采用Dex复合腰硬联合麻醉、对照组采用咪达唑仑复合腰硬联合麻醉;对比两组不同时间的心率(HR)、平均动脉压(MAP)、动脉血氧饱和度(SpO2)水平,血清白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、皮质醇(Cor)、肾上腺素(E)、去甲肾上腺素(NE)、呼气峰值流速、每分钟静息通气量、基础潮气量。【结果】在麻醉前(T0)、麻醉后15 min(T1)、手术结束2 min(T2)时刻,两组的MAP、HR、SpO2测定值比较差异均无显著性(P>0.05);术前,两组的血清各指标比较差异均无显著性(P>0.05);术后24 h,观察组患者的血清IL-6、IL-10、TNF-α、Cor、E、NE水平均低于对照组,且差异有显著性(P<0.05);术中,观察组患者的呼气峰值流速、每分钟静息通气量、基础潮气量均高于对照组(P<0.05)。【结论】Dex复合腰硬联合麻醉较咪达唑仑复合腰硬联合麻醉对患者的炎症应激反应、呼吸功能影响更小。【Objective】To investigate the effect of dexmedetomidine(DEX)combined with spinal epidural anesthesia on inflammatory stress and respiratory function in patients undergoing transurethral resection of the prostate(TURP).【Methods】A total of 100 cases of TURP was randomly divided into two groups,50 cases in each group;The observation group was given DEX combined with combined spinal epidural anesthesia,and the control group was given midazolam combined spinal epidural anesthesia;the heart rate(HR),mean arterial pressure(MAP),arterial oxygen saturation(SpO2)levels,serum interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),cortisol(Cor)and epinephrine(E),norepinephrine(NE),peak expiratory flow rate,resting ventilation volume per minute and basic tidal volume were compared between the two groups at different times.【Results】Before anesthesia(T0),15 minutes after anesthesia(T1),and 2 minutes after operation(T2),there were no significant differences in MAP,HR,SpO2 between the two groups(P>0.05);before operation,there was no significant difference in serum indexes between the two groups(P>0.05);24 hours after operation,the serum levels of IL-6,IL-10,TNF-α,Cor,E,NE in the observation group were lower than those in the control group,and the difference was significant During the operation,the peak expiratory flow rate,resting ventilation volume per minute and basic tidal volume in the observation group were higher than those in the control group(P<0.05).【Conclusion】DEX combined spinal epidural anesthesia has less effect on inflammatory stress response and respiratory function than midazolam combined spinal epidural anesthesia.

关 键 词：右美托咪啶/治疗应用 电外科手术 尿道/外科学 前列腺切除术/方法 呼吸功能试验 

分 类 号：R697.32[医药卫生—泌尿科学]