摘要
目的观察丙泊酚联合右美托咪啶对肺癌根治术后患者炎症因子及感染的影响,为临床治疗提供依据。方法选择2010年7月-2015年3月收治80例行肺癌根治术患者,随机分为对照组及观察组,各40例,两组患者均给予常规抗感染及相关治疗,均给予右美托咪啶镇静,对照组患者联合咪达唑仑,观察组患者联合丙泊酚,观察两组患者不同时间的生命体征,外周血白细胞总数,炎症因子水平,感染发生率及感染评分,记录不良反应发生率。结果对比两组患者用药后生命体征,给药后12及24h,两组患者平均动脉压(MAP)开始升高,心率(HR)、血氧饱和度(SPO2)以及呼气间期(RR)开始下降,两组患者与治疗前相比差异有统计学意义(P<0.05),观察组MAP升高幅度大于对照组,HR、SPO2以及RR降低幅度小于对照组,差异均有统计学意义(P<0.05);观察组WBC及TNF-α、IL-6均低于对照组,IL-10高于对照组,差异有统计学意义(P<0.05);观察组肺部感染率及感染评分均低于对照组,差异有统计学意义(P<0.05);两组患者所有不良反应症状均较轻微,不影响治疗。结论丙泊酚联合右美托咪啶用于肺癌根治术后患者镇痛,疗效显著,不影响患者生命体征,可抑制机体炎症因子释放,减少术后感染发生率,安全性高,不良反应发生率较低。
OBJECTIVE To investigate the effects of propofol and dexmedetomidine on inflammatory factors and in- fections in patients with lung cancer after radical surgery, so as to provide evidence for clinical treatment. METHODS A total of 80 cases of patients with lung cancer after radical surgery from Jul. 2010 to Mar. 2015 were collected, and randomly divided into control group and observation group, with 40 cases in each group. Two groups of patients were given conventional anti-infection and related treatment, and were given dexmedetomidine for sedation. The patients of control group were joint treatment with midazolam, and observation group were giv- en propofol. Vital signs were observed at different time points, and the total number of peripheral blood leuko- cytes, levels of inflammatory factors, the incidence of infection and infection rates, and adverse events were recor- ded. RESULTS Comparison of vital signs of the two groups of patients after treatment, after administration of 12 h and 24 h, the MAP began to increase, and the HR, SPO2 and RR began to decline, and there were significant differences compared with the two groups of patients before treatment（P〈0.05 ）. MAP increased higher in ob- servation group than that in control group, HR, SPO2 and RR reductions were smaller than those in control group, and the differences were significant （P〈0.05） The WBC, TNF-α, and IL-6 of observation group were lower than those of control group, IL-10 was higher, and the differences were significant （P〈0.05）. The inci- dence of pulmonary infection and infection rates of observation group were lower than those of control group, the difference was significant （P〈0.05）, but no significant difference of incision infection rate compared with control group. The symptoms of adverse reactions of the two groups of patients were mild, which did not affect the treat- ment. CONCLUSION Propofol combined with dexmedetomidine has significant effect on postoperative analgesia for patients with lung cancer, does not affect the patient＇s vital signs, inhibit inflammatory cytokine re- leasing and reduce the incidence of postoperative infections. It is safe, with low adverse reactions incidence, and more worthy of promotion.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第20期4686-4688,共3页
Chinese Journal of Nosocomiology
关键词
丙泊酚
右美托咪啶
肺癌根治术
炎症因子
感染
Propofol
Dexmedetomidine given
Lung resection
Inflammatory factors
Infection
