摘要
目的研究乌司他丁与右美托咪定联用对老年糖尿病患者胸腔镜肺叶切除手术围术期血糖水平及免疫炎性因子的作用。方法将2019年1月至2020年6月接受胸腔镜肺叶切除手术的82例老年糖尿病患者纳入研究。按随机数字表法分为联用组和对照组,每组41例。对照组于麻醉诱导前泵入右美托咪定干预,联用组则在对照组的基础上增用乌司他丁静脉泵注干预。比较2组围术期血糖、血流动力学指标以及免疫炎性因子水平变化情况,不良反应发生情况。结果联用组T2、T3、T4时血糖水平均低于对照组,差异有统计学意义(P<0.05)。联用组T2、T3、T4时的MAP以及HR水平均低于对照组,差异有统计学意义(均P<0.05)。联用组T2、T3、T4时血清IL-6、IL-8以及TNF-α水平均低于对照组,差异有统计学意义(均P<0.05)。联用组及对照组谵妄、躁动、低血压发生率比较,差异无统计学意义(均P>0.05)。结论乌司他丁与右美托咪定联用可有效维持老年糖尿病患者胸腔镜肺叶切除手术围术期血糖水平,避免血流动力学紊乱,降低免疫炎性因子水平,且安全性较好,值得临床推广应用。
Objective To investigate the effects of ulinastatin combined with dexmedetomidine on the perioperative blood glucose levels and immune inflammatory factors in elderly patients with diabetes mellitus undergoing thoracoscopic lobectomy.Methods A total of 82 elderly patients with diabetes mellitus who were treated by thoracoscopic lobectomy in our hospital from January 2019 to June 2020 wre enrolled in the study,who were divided into combination treatment group and control group according to random number table method,with 41 cases in each group.The patients in control group were injected with dexmedetomidine before anesthesia induction,however,the patients in combination treatment group,on the basis of control group,were injected with ulinastatin intravenous infusion.The changes of perioperative blood glucose,hemodynamic indexes and immune inflammatory factors as well as the incidence of adverse reactions were observed and compared between the two groups.Results The levels of blood glucose,MAP and HR at T2,T3 and T4 in combination treatment group were significantly lower than those in control group(P<0.05).And the serum levels of IL-6,IL-8 and TNF-αat T2,T3 and T4 in combination treatment group were significantly lower than those in control group(P<0.05).However there were no significant differences in the incidence rates of delirium,agitation and hypotension between the two groups(P>0.05).Conclusion The combination of ulinastatin and dexmedetomidine can effectively maintain the perioperative blood glucose levels in elderly patients with diabetes mellitus undergoing thoracoscopic lobectomy,avoid hemodynamic disorder,and reduce the levels of immune inflammatory factors,with good safety,thus,it is worthy of clinical application and promotion.
作者
刘伟娜
李娟
汪鸿
屈丽虹
LIU Weina;LI Juan;WANG Hong(The Second Affiliated Hospital of Air Force Surgeon University of PLA,Shaanxi,Xi’an 710000,China)
出处
《河北医药》
CAS
2021年第11期1672-1674,1678,共4页
Hebei Medical Journal
