摘要
目的:研究右美托咪定对老年患者深度麻醉后血流动力学、外周血高迁移率族蛋白B1(HMGB1)的影响。方法:76例行腹部手术的老年患者随机分为观察组和对照组,每组38例。在麻醉诱导前观察组静滴右美托咪定,对照组使用等量的0.9%氯化钠注射液。比较两组患者不同时间点吸入七氟烷的浓度,以及麻醉诱导、手术结束时的血流动力学(平均动脉压、心率、心指数、心输出量)、白细胞介素-1β(IL-1β)、HMGB1水平变化,观察两组呼吸恢复时间、睁眼时间及拔管时间,比较两组苏醒情况和药品不良反应。结果:T_1时,两组患者吸入七氟烷的浓度均较T_0时降低,T_2、T_3时,两组患者吸入七氟烷的浓度均较T_0、T_1时有所上升,两组组内不同时段比较差异具有统计学意义(P<0.05);且观察组患者在T_1、T_2、T_3时吸入七氟烷的浓度明显低于对照组(P<0.05)。手术结束时,两组患者的血流动力学指标均较麻醉诱导时有不同程度上升(P<0.05),血清IL-1β、HMGB1水平也有不同程度上升(P<0.05);且观察组患者各项血流动力学指标明显低于对照组(P<0.05),血清IL-1β、HMGB1水平也明显低于对照组(P<0.05)。观察组患者的睁眼时间、呼吸恢复时间、拔管时间明显短于对照组(P<0.05)。两组药品不良反应发生率比较差异无统计学意义(P>0.05)。结论:右美托咪定诱导老年患者深度麻醉能使HMGB1、血流动力学指标处于较为稳定的状态,减少七氟烷用量,确保手术能顺利进行。
Objective： To study the effects of dexmedetomidine on hemodynamic and peripheral blood high mobility group box1protein（ HMGB1） after the depth of anesthesia in elderly patients. Methods： According to the stochastic indicator method,76 cases of elderly patients with abdominal surgery were divided into the observation group and the control group with 38 cases in each. The observation group was treated with dexmedetomidine before the anesthesia induction,and the control group was treated with 0. 9% saline solution with the same volume. The inhalation concentration of sevoflurane at different time points between the groups was compared.During the anesthesia induction and at the end of operation,the blood flow dynamics（ mean arterial pressure,heart rate,heart index and cardiac output）,IL-1 β and HMGB1 were observed and compared between the groups,and the respiratory recovery time,eye opening time and extubation time were also observed and compared,and the recovery of patients and adverse reactions were compared as well. Results： The inhalation concentration of sevoflurane at T_1 in the groups was lower than that at T_0,and that at T_2 and T_3was higher than that at T_0 and T_1,and the differences at various time points in the same group were statistically significant（ P 〈0. 05）,and that at T_1,T_2 and T_3in the observation group was lower than that in the control group（ P 〈0. 05）. At the end of operation,the indices of hemodynamic were increased in varying degrees when compared with those of anesthesia induction（ P 〈0. 05）,the levels of serum IL-1β and HMGB1 were also increased in varying degrees（ P 〈0. 05）,and all the above indices in the observation group were lower than those in the control group（ P 〈0. 05）. The time of eye opening,respiratory recovery and extubation in the observation group was shorter than that in the control group（ P 〈0. 05）. There was no statistically significant difference in adverse reactions between the groups（ P 〈0. 05）. Conclusion： Depth of anesthesia induced by dexmedetomidine in elderly patients can keep the stable state of HMGB1 and hemodynamic indices with reduced sevoflurane dosage,which ensure to make surgery smoothly.
出处
《中国药师》
CAS
2016年第8期1494-1496,共3页
China Pharmacist
关键词
右美托咪定
深度麻醉
血流动力学
外周血高迁移率族蛋白B1
Dexmedetomidine
Depth of anesthesia
Hemodynamic
Peripheral blood high mobility group box1 protein
