右美托咪定联合利多卡因注射液对全麻下腹腔镜全子宫切除术患者应激反应和Th1、Th2细胞因子的影响  

Effects of Dexmedetomidine Combine with Lidocaine Injection on Stress Response and Th1,Th2 Cytokines in Patients Undergoing Laparoscopic Total Hysterectomy under General Anesthesia

作　　者：廖丽芳 张成 柳真芳 龙月秋 刘艳秋 LIAO Li-fang;ZHANG Cheng;LIU Zhen-fang;LONG Yue-qiu;LIU Yan-qiu(College of Anesthesiology,Guizhou Medical University,Guiyang,Guizhou,550025,China;Department of Anesthesiology,Hezhou People's Hospital,Hezhou,Guangxi,542800,China;Department of Gynaecology and Obstetrics,Hezhou People's Hospital,Hezhou,Guangxi,542800,China;Department of Anesthesiology,Guiyang Fourth People's Hospital,Guiyang,Guizhou,550007,China)

机构地区：[1]贵州医科大学麻醉学院,贵州贵阳550025 [2]贺州市人民医院麻醉科,广西贺州542800 [3]贺州市人民医院妇产科,广西贺州542800 [4]贵阳市第四人民医院麻醉科,贵州贵阳550007

出　　处：《现代生物医学进展》2023年第20期3918-3922,共5页Progress in Modern Biomedicine

基　　金：贵州省卫生计生委科学技术基金项目(gzwjkj2016-1-007)。

摘　　要：目的:探讨利多卡因注射液、右美托咪定联合应用对全麻下腹腔镜全子宫切除术患者辅助性T细胞(Th)1、Th2细胞因子和应激反应的影响。方法:选取2019年5月~2022年12月期间贺州市人民医院收治的行全麻下腹腔镜全子宫切除术患者(n=90),按照随机数字表法分为研究组(利多卡因复合右美托咪定,45例)、对照组(利多卡因,45例)。对比两组麻醉常规评分、术后恢复质量、应激反应指标、Th1、Th2细胞因子水平和不良反应发生率。结果:与对照组术后6 h、术后12 h相比,研究组Ramsay镇静评分更高,疼痛视觉模拟量表(VAS)评分更低(P<0.05)。研究组拔管时间短于对照组,苏醒时间长于对照组(P<0.05)。与对照组术后1 d相比,研究组白介素(IL)-6、肿瘤坏死因子-α(TNF-α)和丙二醛(MDA)更低,总抗氧化态(TAS)更高(P<0.05)。与对照组术后1 d相比,研究组IL-2、Th1、Th1/Th2更低,IL-10、Th2更高(P<0.05)。两组不良反应发生率组间对比未见差异(P>0.05)。结论:与单用利多卡因注射液相比,联合右美托咪定应用于全麻下腹腔镜全子宫切除术患者,具有良好的镇静、镇痛效果,减轻机体应激,调节Th1、Th2平衡,有利于患者术后恢复。Objective:To observe the effects of dexmedetomidine combine with lidocaine injection on stress response and Helper T cells(Th)1,and Th2 cytokines in patients undergoing laparoscopic total hysterectomy under general anesthesia.Methods:Patients(n=90)underwent laparoscopic total hysterectomy under general anesthesia and who were admitted to the Hezhou People's Hospital from May 2019 to December 2022 were selected,and they were divided into study group(lidocaine combined with dexmedetomidine,45 cases),control group(lidocaine,45 cases)according to the random number table method.The conventional anesthesia scores,recovery quality at after surgery,stress response indicators,Th1 and Th2 cytokine levels,and incidence of adverse reactions were compared between the two groups.Results:Compared with the control group 6h after surgery and 12 h after surgery,the Ramsay sedation scores in the study group was higher,and the pain visual analogue scale(VAS)scores was lower(P<0.05).The extubation time of the study group was shorter than those in the control group,and the awakening time was longer than that of the control group(P<0.05).Compared with the control group 1 d after surgery,the interleukin(IL)-6,tumor necrosis factor-α(TNF-α),malondialdehyde(MDA)in the study group were lower,and the total antioxidant status(TAS)was higher(P<0.05).Compared with the control group at 1 d after surgery,IL-2,Th1 and Th1/Th2 in the study group were lower,IL-10 and Th2 were higher(P<0.05).There was no difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Compared with lidocaine injection alone,the combination of lidocaine injection and dexmedetomidine has good sedative and analgesic effects in patients undergoing laparoscopic hysterectomy under general anesthesia,reducing body stress,regulating Th1 and Th2 balance,and promoting postoperative recovery.

关 键 词：右美托咪定 腹腔镜全子宫切除术 利多卡因注射液 TH1细胞因子 TH2细胞因子 应激反应 

分 类 号：R713.4[医药卫生—妇产科学]