摘要
目的探讨不同剂量右美托咪定对老年腹腔镜手术患者镇痛、应激以及免疫功能的影响。方法将126例腹腔镜手术患者随机分为低剂量组42例、中剂量组42例和高剂量组42例。低、中、高3个剂量组分别在麻醉前15 min予以静脉注射0.2,0.4,0.6μg·kg-1·h-1右美托咪定。比较3组患者术前、术后3,8,24 h的镇痛评分、舒张压、收缩压、血糖、心率以及CD4、CD8、CD4/CD8水平。结果术前和术后24 h,3组患者的镇痛评分比较差异无统计学意义(P>0.05)。术前和术后24 h,3组患者的舒张压、收缩压、血糖、心率比较差异无统计学意义(P>0.05)。术后3,8 h,中、高剂量组患者的镇痛评分明显高于低剂量组(P<0.05)。术后3,8 h,中、高剂量组的舒张压、收缩压、血糖、心率水平明显优于低剂量组(P<0.05)。术前和术后,3组患者的的CD4水平比较差异无统计学意义(P>0.05)。术前和术后3 h,3组患者的CD8、CD4/CD8水平比较差异无统计学意义(P>0.05)。术后8,24 h,中、高剂量组患者的CD8水平明显低于低剂量组,且CD4/CD8比值明显优于低剂量组(P<0.05)。结论用0.4,0.6μg·kg-1·h-1右美托咪定对老年腹腔镜手术患者有着更为明显的镇痛功效,可减轻应激反应,改善患者的免疫功能,值得广泛推广使用。
〉Objective To study the effect ofdifferent doses of dexmedetomidine to pain,stress and immune function in elderly patients with laparoscopic surgery Methods One hundred twenty- six patients of laparoscopic surgery were randomly divided into low- dose group（ 42 cases）,middle dose group（ 42 cases）,and high- dose group（ 42 cases）. Before anesthesia 15 min,the low dose group,middle dose group and high dose groups were intravenouslygiven 0. 2,0. 4,0. 6 μg · kg- 1·h- 1of dexmedetomidine,respectively. Diastolic bllod pressure（ DBP）,systolic blood pressure（ SBP）,blood sugar（ Glu）,heart rate（ HR） to the horizontal and CD4,CD8,CD4 / CD8 levels of before and after surgery 3,8,24 h were compared. Results The pain scores,DBP,SBP,Glu and HR levels of before and after surgery 24 h between three groups were not significant differences（ P 〈0. 05）. After surgery 3 h and 8 h,pain scores of middle high dose groups were significantly higher than that of low- dose group（ P〈 0. 05） and their DBP,SBP,Glu,HR were significantly better than that of low- dose group（ P 〈0. 05）. Before and after surgery,CD4 levels in three groups of patients did not change significantly. Before and 3 h after surgery,CD8,CD4 / CD8 levels in the three groups were not significant difference（ P 〉0. 05）. After surgery 8 h and 24 h,CD8 levels of high- dose group was significantly lower than of the low- dose group,and the CD4 / CD8 ratio was significantly better than low-dose group（ P〈 0. 05）. Conclusion The use of 0. 4,0. 6 μg ·kg- 1·h- 1dexmedetomidine scheduled for laparoscopic surgery in elderly patients have a more significant analgesic effect,can reduce stress and improve immune function in patients,it is worth widely used.
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2015年第17期1709-1712,共4页
The Chinese Journal of Clinical Pharmacology
基金
浙江省医药卫生平台骨干人才计划基金资助项目(2011RCB026)
关键词
右美托咪定
腹腔镜手术
镇痛
应激
免疫功能
dexmedetomidine
laparoscopic surgery
analgesia
stress
immune function
