摘要
目的:探讨腹腔镜手术(LS)应用右美托咪定(Dex)辅助麻醉对患者苏醒期血清皮质醇(COR)、醛固酮(ALD)及炎症因子水平的影响。方法:选取我院2015年3月~2017年3月收治并择期行LS治疗的138例患者,采取随机数字表法均分为两组。所有患者均采取相同的常规静吸复合麻醉,观察组在此基础上于麻醉诱导前15 min(T_0)静脉滴注负荷剂量为1μg/kg的Dex、而后以0.5μg/(kg·h)速度持续静脉泵注Dex至术毕前10 min,对照组以等剂量生理盐水重复以上操作。记录比较两组T0和拔管后15 min(T_1)应激反应指标、炎症因子水平,麻醉苏醒期镇静-躁动评分(SAS)及术后不良反应的发生情况。结果:与T_0时相比,两组T1时血清COR、ALD、CRP、TNF-α、IL-6水平均显著升高(P<0.01),且观察组以上指标均显著低于对照组(P<0.01)。观察组麻醉苏醒期SAS评分为(2.96±0.32)分,显著低于对照组【(4.14±0.38)分】(P<0.01)。观察组术后不良反应率为4.3%,较对照组(15.9%)明显降低(P<0.05)。结论:应用右美托咪定辅助麻醉更能有效降低腹腔镜手术患者苏醒期应激反应,抑制机体炎症反应,提高苏醒质量,且安全性高。
Objective： To investigate the effects of dexmedetomidine （Dex） on the levels of serum corfisol （COR）, aldosterone （ALD） and inflammatory cytokines of patients undergoing laparoscopic surgery （LS）. Methods： 138 patients treated with LS in our hospi- tal from March 2015 to March 2017 were selected and equally divided into two groups with the method of random number table. All the patients were treated with the same conventional inhalation anesthesia, on the basis of which, the observation group were injected with intravenous drip loading dose of 1 μg/kg Dex 15rain （To） before the anesthesia induction, and then continuous intravenous infusion of Dex at the speed of 0.5 μg/ （kg.h） to preoperative the 10 min. The control group was given the same dose of saline following the above induction. The stress response index, inflammatory factor levels, the sedation agitation scale （SAS） and the adverse reaction were recored and compared between the two groups at To and 15 min after the extubation （T1）. Results： Compared with those at To, the serum COR, ALD, CRP, TNF-α and IL-6 levels of both groups at T1 were significantly increased（P〈0.01 ）, which were significantly lower in the obser- vation group than those of the control group （P〈0.01）. The SAS score of observation group was （2.96± 0.32） during the anesthesia recovery period, which was significantly better than that of the control group （4.14± 0.38, P〈0.01）. The incidence rate of adverse reaction in the observation group was 4.3%, which was significantly lower than that of the control group （15.9%, P〈0.05）. Conclusion： Dexmedetomi- dine assisted anesthesia could effectively reduce the stress reaction of patients undergoing laparoscopic surgery during the recovery peri- od, inhibit the inflammatory response and improve the quality of recovery with high safety.
作者
刘梅
胡彬
李玲霞
刘斌
高峰
LIU Mei1, HU Bin1 , LI Ling-xia1, LIU Bin2, GAO Feng2(1 Department of Anesthesiology, AflTliated Hospital of Yah＇an University, Yan＇an, Shaanxi, 716000, China; 2 Department ofgeneral surgery, AflTliated Hospital of Yah＇an University, Yah＇an, Shaanxi, 716000, Chin)
出处
《现代生物医学进展》
CAS
2018年第5期927-930,942,共5页
Progress in Modern Biomedicine
基金
陕西省科技攻关项目(201205312)
关键词
腹腔镜手术
右美托咪定
苏醒期
应激反应
炎症因子
Laparoscopic surgery
Dexmedetomidine
Recovery period
Stress response
Inflammatory factors
