摘要
【目的】探讨右美托咪定对肺部手术患者抗氧化能力、一氧化氮（NO）水平及心肺功能的影响。【方法】择期全麻肺部手术患者76例随机分为对照组（c组）和右美托咪定组（D组），备38例。开胸前（T0）、单肺通气（OLV）后60min（T1）、术毕即刻（T2）检测肿瘤坏死因子（TNF—α）、白介素6（IL-6）、NO、丙二醛（MAD）、超氧化物歧化酶（SOD），并于Tn～T2时测定心搏指数（SI）、心脏指数（CI）、气道平台压、气道阻力和肺顺应性；记录两组围手术期不良反应。【结果】与T0时相比，两组T1、T2时TNF—α、IL-10、TNF-α、IL-10、NO、MDA均升高，SOD降低（P〈0．05）；与C组T，、T：时相比，D组TNF—ot、IL一10、NO、MDA较低，SOD较高（P〈0．05）。与T0时相比，D组T1、T2时SI、CI、气道平台压、气道阻力、肺顺应性无明显变化（P〉0．05），C组TI时上述指标无变化（P〉0．05），T2时SI、CI均降低，气道平台压、气道阻力、肺顺应性均升高（P〈0．05）；与C组T2时比较，D组SI、CI较高，气道平台压、气道阻力、肺顺应性较低（P〈0．05）。D组围手术期不良反应发生率为7．89％明显低于c组的26．32％（P〈0．05）。【结论】肺部手术患者围手术期给予右美托咪定，可降低炎性水平；减轻氧化应激损伤，有利于心肺功能恢复。
[ Objective] To explore the effects of dexmedetomidine on oxidation resistance, nitric oxide （NO） level and cardiopulmonary function in patients undergoing lung surgery. [ Methods ] A total of 76 patients who received pulmqnary surgery under general anesthesia were divided into a control group （group C） and a dexmedetomidine group （group D）, with 38 cases each. Tumor necrosis factor （ TNF-α）, interleukin-6 （ IL-6）, NO level, malonaldehyde （ MAD）, and superoxide dismutase （SOD） were detected before opening the chest （To ）, 60min after OLV （T1 ） and at the end of operation （T2 ）. Stroke index （SI）, cardiac index （CI）, airway plateau pressure, air way resistance and lung compliance at TO to T2 were determined as well. Adverse drug reactions in two groups during the perioperative period were recorded： [ Results ] Compared to those at TO, TNF-α, IL-10, TNF-α, IL-6, IL-10,1 NO, MDA in the two groups at T1 and T2 were significantly increased, while SOD level was significantly decreased （ P 〈 0.05 ）. Compared to group C at T1 and T2, TNF-α, IL-10, NO, MDA in the group D were significantly lower; however, SOD was significantly higher （ P 〈 0.05）. In group D, there were no significant changes in SI, CI, airway plateau pressure, air way resistance and lung compliance at T1 and T2 compared to To （ P 〉 0.05）. The above indexes in group C at T1 were not changed （P 〉 0.05）, but SI, CI at T2 were significantly decreased. Airway plateau pressure, airway resistance and lung compliance were significantly increased （ P 〈 0.05 ）. Compared to group C at T2, SI and CI in group D were significantly higher and airway plateau pressure, air way resistance and lung compliance were significantly lower （ P 〈 0.05）. The adverse reaction rate during the perioperative period of group D was 7.89%, was significantly lower than that of group C, which was 26.32% （ P 〈 o. 05 ）. [ Conclusion ] The application of dexmedetomid^ne in lung surgery during the perioperative period can reduce inflammatory levels and alleviate oxidative stress injury. It is beneficial to the recovery of cardiopulmonary function.
出处
《医学临床研究》
CAS
2017年第1期29-31,35,共4页
Journal of Clinical Research
