盐酸右美托咪定预处理对创伤性休克患者炎性反应及术后谵妄的影响  

Effects of Pretreatment with Dexmedetomidine Hydrochloride on Inflammatory Reaction and Postoperative Delirium in Patients with Traumatic Shock

作　　者：吴隆延[1] 仲志栋[1] 景璟 WU Long-yan;ZHONG Zhi-dong;JING Jing(Department of Anesthesiology,Kowloon Hospital,Shanghai Jiaotong University Medical School,Suzhou 215028,China)

机构地区：[1]上海交通大学医学院苏州九龙医院麻醉疼痛科,上海215021

出　　处：《药物生物技术》2022年第5期494-497,共4页Pharmaceutical Biotechnology

基　　金：江苏省苏州市科技发展计划项目(No.SYSD2016054)。

摘　　要：探讨盐酸右美托咪定预处理对创伤性休克患者炎性反应及术后谵妄的影响。选择80例创伤性休克患者为研究对象,随机分为两组:盐酸右美托咪定组(A组n=40)和常规组(B组n=40);所有患者入室后均开放外周静脉,A组给予盐酸右美托咪定1μg/kg经静脉泵注(15 min)预处理;B组给予常规诱导,且于麻醉前(T0)、切皮前(T1)、手术开始后1 h(T2),3 h(T3),6 h(T4),12 h(T5),24 h(T6),48 h(T7),72 h(T8)各时点测定血清IL-6、IL-8、IL-10及血乳酸浓度值。并于术前,术后12 h及术后第1,2,3,7 d随访病人,用意识模糊谵妄评定法进行谵妄评估。两组炎性指标及血乳酸浓度值T0~T1时点无明显差异(P>0.05);A组T2时点之后血清IL-6、IL-8及血乳酸浓度值较B组明显偏低,且IL-10浓度值较B组明显偏高(P<0.05)。A组发生术后谵妄6例(发生率为15%),B组发生术后谵妄18例(发生率为45%),A组术后谵妄发生率较B组明显偏低(P<0.05)。盐酸右美托咪定预处理不仅能明显减轻创伤性休克患者炎性反应,且能显著降低创伤性休克患者术后谵妄的发生率。To investigate the effect of dexmedetomidine hydrochloride pretreatment on inflammatory reaction and postoperative delirium in patients with traumatic shock,80 patients with traumatic shock were randomly divided into two groups:dexmedetomidine hydrochloride group(group A,n=40)and routine group(group B,n=40).All patients were opened peripheral vein after entering the room.Group A was pretreated with dexmedetomidine hydrochloride 1μg/kg by intravenous pump(15 min);Group B was given routine induction,and the serum IL-6,IL-8,IL-10 and blood lactic acid concentrations were measured before anesthesia(T0),before skin incision(T1),1 h(T2),3 h(T3),6 h(T4),12 h(T5),24 h(T6),48 h(T7)and 72 h(T8)after operation.The patients were followed up before operation,12 hours after operation and 1,2,3,7 days after operation,and the delirium was assessed by fuzzy delirium assessment.There was no significant difference in inflammatory index and blood lactic acid concentration between the two groups at T0-T1(P>0.05).After T2,the levels of serum IL-6,IL-8 and blood lactic acid in group A were significantly lower than those in group B,and the level of IL-10 was significantly higher than that in group B(P<0.05).Postoperative delirium occurred in 6 cases(15%)in group A,and 18 cases(45%)in group B.The incidence of postoperative delirium in group A was significantly lower than that in group B(P<0.05).Dexmedetomidine hydrochloride pretreatment can not only significantly reduce the inflammatory reaction in patients with traumatic shock,but also significantly reduce the incidence of postoperative delirium in patients with traumatic shock.

关 键 词：盐酸右美托咪定 创伤性休克 炎性反应 术后谵妄 

分 类 号：R971[医药卫生—药品]