不同剂量右美托咪定联合丙泊酚全凭静脉麻醉对食管癌根治术患者炎症因子、氧化应激和术后谵妄的影响  

Effects of Different Doses of Dexmedetomidine Combined with Propofol Total Intravenous Anesthesia on Inflammatory Factors,Oxidative Stress and Postoperative Delirium in Patients Undergoing Radical Resection of Esophageal Cancer

作　　者：谷晓慧 于巍[2] 余小燕 李吉尧 苏小虎 GU Xiao-hui;YU Wei;YU Xiao-yan;LI Ji-yao;SU Xiao-hu(Department of Anesthesia and Perioperative Medicine,Suqian First People's Hospital Affiliated to Nanjing Medical University,Suqian,Jiangsu,223800,China;Department of Anesthesiology,The Fourth Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang,150001,China;Department of Cardiothoracic Surgery,Suqian First People's Hospital Affiliated to Nanjing Medical University,Suqian,Jiangsu,223800,China)

机构地区：[1]南京医科大学附属宿迁第一人民医院麻醉与围术期医学科,江苏宿迁223800 [2]哈尔滨医科大学附属第四医院麻醉科,黑龙江哈尔滨150001 [3]南京医科大学附属宿迁第一人民医院胸心外科,江苏宿迁223800

出　　处：《现代生物医学进展》2023年第8期1584-1589,共6页Progress in Modern Biomedicine

基　　金：中国博士后科学基金项目(2019M651301)。

摘　　要：目的:探讨不同剂量右美托咪定联合丙泊酚全凭静脉麻醉对食管癌根治术患者炎症因子、氧化应激和术后谵妄的影响。方法:选择南京医科大学附属宿迁第一人民医院2019年1月~2021年12月期间120例择期行食管癌根治术的患者。按照随机数字表法将患者分为对照组(41例,丙泊酚全凭静脉麻醉)、低剂量组(40例,对照组基础上联合0.50μg/kg右美托咪定麻醉)、高剂量组(39例,对照组基础上联合1.00μg/kg右美托咪定麻醉)。对比三组神经损伤指标、炎症因子、氧化应激相关指标,同时记录三组不良反应发生率和术后谵妄发生率。结果:高剂量组、低剂量组T2~T4时间点S100β蛋白、神经元特异性烯醇化酶(NSE)低于对照组,且高剂量组低于低剂量组(P<0.05)。高剂量组、低剂量组T2~T4时间点肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白介素-6(IL-6)、白介素-1β(IL-1β)低于对照组,且高剂量组低于低剂量组(P<0.05)。高剂量组、低剂量组T2~T4时间点超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)高于对照组,且高剂量组高于低剂量组(P<0.05)。高剂量组、低剂量组T2~T4时间点丙二醛(MDA)低于对照组,且高剂量组低于低剂量组(P<0.05)。三组麻醉期间不良反应发生率对比无差异(P>0.05)。高剂量组的术后谵妄发生率低于低剂量组、对照组(P<0.05)。结论:1.00μg/kg剂量的右美托咪定联合丙泊酚全凭静脉麻醉用于食管癌根治术患者麻醉效果较好,可降低术后谵妄发生率,有效控制氧化应激和炎症因子水平。Objective:To investigate the effects of different doses of dexmedetomidine combined with propofol total intravenous anesthesia on inflammatory factors,oxidative stress and postoperative delirium in patients undergoing radical resection of esophageal cancer.Methods:120 patients who underwent elective radical resection of esophageal cancer in Suqian First People's Hospital Affiliated to Nanjing Medical University from January 2019 to December 2021 were selected.According to random number table method,patients were divided into control group(41 cases,propofol total intravenous anesthesia),low-dose group(40 cases,on the basis of control group combined with 0.50μg/kg dexmedetomidine anesthesia),and high-dose group(39 cases,on the basis of control group combined with 1.00μg/kg dexmedetomidine anesthesia).Neurological injury indicators,inflammatory factors and oxidative stress related indicators were compared in the three groups,and the incidence rate of adverse reactions and postoperative delirium were recorded in the three groups.Results:S100βprotein and neuron-specific enolase(NSE)in the high-dose group and low-dose group at T2~T4 time points were lower than those in the control group,and the high-dose group was lower than the low-dose group(P<0.05).Tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6)and interleukin-1β(IL-1β)in the high-dose group and low-dose group at T2~T4 time points were lower than those in control group,and high-dose group was lower than the low-dose group(P<0.05).The levels of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)in the high-dose group and low-dose group at T2~T4 time points were higher than those in the control group,and the high-dose group was higher than the low-dose group(P<0.05).The malondialdehyde(MDA)in the high-dose group and low-dose group at T2~T4 time points was lower than that in the control group,and the high-dose group was lower than the low-dose group(P<0.05).There was no difference in the incidence rate of adverse reactions duri

关 键 词：右美托咪定 丙泊酚 全凭静脉麻醉 食管癌根治术 炎症因子 氧化应激 谵妄 

分 类 号：R735.1[医药卫生—肿瘤] R614[医药卫生—临床医学]