摘要
目的:探讨不同剂量右美托咪定对单肺通气(OLV)患者围术期炎症因子及肺氧合功能的影响。方法:选取2016年10月—2017年3月收治的60例择期行肺叶切除术患者,根据右美托咪定剂量随机将其分为A组(20例)、B组(20例)和C组(20例)。于麻醉诱导前,B组、C组以1μg/kg静脉输注右美托咪定10 min,其浓度为4μg/mL,随后分别以0.2μg·kg^(-1)·h^(-1)及0.5μg·kg^(-1)·h^(-1)持续输注至术前半小时;A组给予生理盐水对照。于OLV起始时刻(t0),OLV后60 min(t1)和恢复双肺通气15 min(t2)时采集桡动脉血,采用酶联免疫法(ELISA)检测肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-10(IL-10)浓度。同时行血气分析,记录氧合指数(OI)。结果:与t0比较,t_1、t_2时刻三组TNF-α、IL-6、IL-10浓度均增加,OI减小,差异有统计学意义(P<0.05);与A组比较,B组在t_1时刻IL-6浓度较A组低,在t_2时刻TNF-α、IL-6浓度降低,IL-10浓度及OI升高;C组在t_1、t_2时刻TNF-α、IL-6浓度降低,IL-10浓度升高,OI增大,差异均有统计学意义(P<0.05);与B组比较,C组在t_1、t_2时刻TNF-α、IL-6降低,IL-10升高,OI增大,差异有统计学意义(P<0.05)。结论:右美托咪定可减少单肺通气过程中炎症因子的释放,改善肺氧合功能,对围术期肺保护起到一定的积极作用。
Objective：To investigate the effects of different doses dexmedetomidine on inflammatory factor and oxygenation during One Lung Ventilation（OLV）.Methods：Sixty ASA Ⅰ or Ⅱ patients undergoing OLV during VATS were randomly allocated to three groups（ n =20）：control group （group A）,low dosage Dex group （group B） and high dosage Dex group （group C）.In the group B and C,additional infusion of dexmedetomidine （1 μg/kg） was administered 10minutes before intubation,and a continuous injection of Dex（0.2,0.5 μg·kg -1 ·h -1 respectively） succeed until 30 minutes before the end of operation.While in group A,received only normal saline instead of Dex.Arterial blood samples were collected before OLV （ t 0 ）,at 60 min after OLV （ t 1 ）,at 15 min after reexpansion of the collapsed lung （ t 2 ） for blood gas analysis.Oxygenation was recorded at the same time.The consumption of propofol was recorded and side effects were observed.Results：Compared with those at t 0 ,the levels of TNF-α,IL-6,IL-10 were significantly higher at the time of t 1 and t 2 in both groups （ P 〈0.05）.Compared with group A,the levels of IL-6 in group B were lower at the time of t 1 and t 2 （ P 〈0.05）,the levels of TNF-α were lower and the IL-10 were higher in group B at the time of t 2 （ P 〈0.05）.The levels of TNF-α,IL-6 were lower and the IL-10 were higher in group C at the time of t 1 and t 2 （ P 〈0.05）.Compared with group B,the levels of TNF-α,IL-6 were lower and the levels of IL-10 were higher in group C at the time of t 1 and t 2 （ P 〈0.05）.OI were significantly decreased at the time of t 1 and t 2 compared with t0 in both groups （ P 〈0.05）.Compared with group A,OI were higher in group B at the time of t 2 ,in group C were higher at the time of t 1 and t 2 （ P 〈0.05）.Compared with group B,OI were higher in group C at the time of t 1 and t 2 （ P 〈0.05）.The consumption of propofol was remarkably lower in group B and C.Compared with group A and B,hypoten
作者
刘洋
高东艳
LIU Yang;GAO Dongyan(Shanxi Medical University,Taiyuan 030001,China;The Second Affiliated Hospital of Shanxi Medical University,Taiyuan 030001)
出处
《临床医药实践》
2018年第7期491-494,共4页
Proceeding of Clinical Medicine
