摘要
目的观察右美托咪定在单肺通气患者中的非通气侧肺损伤的相关指标的改善作用。方法纳入2014年1月~2016年12月的进行肺癌根治术患者共60例,随机分为对照组及观察组,各30例,两组患者在经气管插管通气成功后,观察组经20 min静脉输注右美托咪啶共0.5μg/kg,随后以0.6μg/(kg·h)速率静脉输注至关胸,对照组则注射同等容量的生理盐水。对比两组患者分别在单肺通气即刻(T1)、单肺通气1 h(T_2)、单肺通气结束即刻(T3)时刻及手术完毕(T4)时的缺氧诱导因子-1α(HIF-1α)和血红素加氧酶(HO-1)、肺损伤评分、TNF-α、IL-6和IL-8。结果较T_1时对比,T_3和T_4时HIF-1α和HO-1均出现升高(P<0.05),在T_3和T_4时,观察组HIF-1α和HO-1均出现升高(P<0.05);两组患者T_1和T_2时肺损伤评分对比差异无统计学意义,在T_3和T_4时观察组评分低于对照组(P<0.05),在T_3和T_4时,两组较T_1时评分均出现升高(P<0.05);较T_1时对比,T_2、T_3和T_4时TNF-α、IL-6和IL-8均出现升高(P<0.05),在T_2、T_3和T_4时,观察组TNF-α、IL-6和IL-8较对照组均出现下降(P<0.05),对比差异有统计学意义。结论在肺癌根治术患者单肺通气期间采用右美托咪定能有效的减轻患者的非通气侧肺损伤,其机制与HIF-1α和HO-1上调及减轻了肺组织炎症反应有一定的关系。
Objective To observe the improvement effect of dexmedetomidine on non ventilated lung injury in one lung ventilation patients.Methods A total of 60 patients with radical resection of lung cancer from January 2014 to December 2016 were randomly divided into the control group and the observation group（30 cases each）. After the tracheal intubation was successful in the two groups, the observation group was injected with 20 min intravenous infusion of right metoimidin 0.5 μg/kg, and then the 0.6 μg/（kg·h）rate was injected to the chest and the control group. The same volume of physiological saline was injected. The two groups were compared with single lung ventilation immediately（T1）, single lung ventilation 1 H（T2）, single lung ventilation end immediate（T3） time and operation completion（T4）, the hypoxia inducible factor-1 alpha（HIF-1 alpha） and heme oxygenase（HO-1）, lung injury score, TNF-, IL-6 and IL-8. Results Compared with T1, HIF-1 alpha and HO-1 increased at T_3 and T4（P0.05）. At T_3 and T_4, HIF-1 alpha and HO-1 increased in the observation group（P0.05）, and there was no difference in the score of lung injury between the two groups. The score of the observation group was lower than that of the control group（P0.05）. The two groups were compared with those of the two groups. Compared with T1, TNF-a, IL-6 and IL-8 increased（P0.05） at T_2, T_3 and T_4 compared with T1（P0.05）. In T_2, T_3, and T_4,the observation group was decreased in comparison with those of the control group, and the difference was statistically significant. Conclusion Dexmedetomidine can effectively reduce the non ventilated lung injury during the single lung ventilation in patients with lung cancer, and the mechanism is related to the up regulation of HIF-1 alpha and HO-1 and alleviating the inflammatory reaction in the lung tissue.
作者
刘新结
夏开群
Liu Xinjie, Xia Kaiqun(Department of Anesthesiology, Yiyang Central Hospital, Yiyang, Hunan, 413000, China)
出处
《当代医学》
2018年第19期113-115,共3页
Contemporary Medicine
关键词
右美托咪定
呼吸
人工
肺损伤
Dexmedetomidine
Respiration
Artificial
Lung injury
