摘要
目的探讨右美托咪定预处理对肝脏手术后患者肺损伤的影响。方法选择2009年8月到2014年2月在我院择期行肝脏手术患者60例,根据随机抽签原则分为治疗组与对照组各30例,2组均给予单肺通气麻醉,与对照组不同的是治疗组麻醉诱导后选择持续静脉泵注右美托咪定;所有患者于麻醉诱导前(T0)、关胸(T1)、术后即刻(T2)进行血气分析、炎症因子表达检测与肺部功能分析。结果 2组舒张压和心率在3个时间点(T0、T1、T2)组内和组间比较差异均无统计学意义(P>0.05)。2组T1与T2时间点的TNF-α和SP-D表达量明显高于T0时间点(P<0.05),同时T1与T2时间点治疗组的TNF-α和SP-D表达量明显低于对照组(P<0.05)。治疗组T2、T3时间点的气道平台压和气道阻力明显低于T1时间点(P<0.05),与对照组对比差异也有统计学意义(P<0.05)。结论肝脏手术单肺通气患者麻醉中应用右美托咪定能够抑制炎性反应,同时改善肺部气道平台压和气道阻力,对于血气无明显影响,从而有效发挥肺功能保护作用。
Objective To investigate the effects of dexmedetomidine pretreatment on lung injury for patients after liver surgery. Methods Sixty patients who had liver surgery in our hospital from August 2009 to February 2014 were equally divided into the treatment group and the control group,with 30 patients in each group. Both of the two groups were given one-lung ventilation anesthesia. Patients in the treatment group were given continuous intravenous infusion of dexmedetomidine after induction of anesthesia while paitents in the control group were not. In the time of before induction of anesthesia（ T0）,closed chest（ T1）,immediately after surgery（ T2）,all patients were given the gas analysis,expression of inflammatory cytokines and lung function testing and analysis. Results The diastolic blood pressure and heart rate at time points of T0,T1 and T2 in the two groups showed no significant difference（ P〈0. 05）. And the expression of TNF-α and SP-D at time points of T1 and T2 in the two groups were significantly higher than those at T0（ P〉0. 05）; while the expression of TNF-α and SP-D in the treatment group were significantly lower than those in the control group at time points of T1 and T2（ P〈0. 05）. The plateau airway pressure and airway resistance in the treatment group at T2 and T3 were significantly lower than that at T1（ P〈0. 05）,and there were statistically significant differences compared with the control group（ P〈0. 05）. Conclusion The dexmedetomidine pretreatment for the liver surgery patients can inhibit the inflammatory response,while improve lung airway plateau pressure and airway resistance. It has no significant effect for blood,so it can play a protective role for lung function.
出处
《局解手术学杂志》
2015年第5期553-556,共4页
Journal of Regional Anatomy and Operative Surgery
关键词
右美托咪定
肝脏手术后
肺损伤
炎症因子
dexmedetomidine
liver surgery
lung injury
inflammatory factors
