摘要
目的 探讨乌司他丁联合不同剂量右美托咪定对妇科腹腔镜子宫切除术患者血流动力学及血清神经元特异性烯醇化酶(NSE)、中枢神经特异性蛋白(S100β)水平的影响。方法 选取2017年5月—2020年9月来九江市第一人民医院妇科行腹腔子宫切除术治疗的78例患者,按照随机数字表法划分成A、B、C组3组,每组均26例。3组均给予全麻,均应用乌司他丁,且均于麻醉诱导前10 min给予右美托咪定负荷量1.0μg/kg,随后A、B、C组分别以0.2、0.4、0.6μg/(kg·h)泵注右美托咪定维持至术毕。比较3组麻醉诱导前10 min(T0)、气管插管后1 min(T1)、气腹后1 min(T2)及手术结束即刻(T3)血流动力学指标[平均动脉压(MAP)、心率(HR)]、血清炎症细胞因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]水平与血清NSE、S100β水平及围术期不良反应发生情况。结果 T1、T2时A、B组MAP与T0时相比明显较高(均P<0.05),T3时A组MAP仍明显高于T0时(P<0.05),而B组MAP与T0时相比差异无统计学意义(均P>0.05),T1~3时C组MAP与T0时相比差异均无统计学意义(均P>0.05),且C组各时间点MAP与同期A、B组相比均明显较低(均P<0.05);T1、T2时A组HR与对照组相比明显较高(均P<0.05),而B、C组HR与对照组相比明显较低(均P<0.05),3组T3时HR与T0时相比差异均无统计学意义(均P>0.05),T1~3时B、C组HR与A组相比明显较低(均P<0.05),B、C组组间比较差异无统计学意义(均P<0.05);T1~3时3组血清TNF-α、IL-6、NSE及S100β水平与治疗前相比均明显升高(均P<0.05),但C组上述血清指标水平与同期A、B组相比均明显较低(均P<0.05),而B组与同期A组相比均明显较低(均P<0.05);3组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 在使用乌司他丁基础上于麻醉诱导前10 min静脉输注1.0μg/kg右美托咪定,随后以0.6μg/(kg·h)持续泵注更有利于稳定腹腔镜子宫切除术患者血流动力学,缓解其术中炎症反应,并能抑�
Objective To investigate the effects of ulinastatin combined with different doses of dexmedetomidine on hemodynamics and serum neuron specific enolase(NSE) and central nerve specific protein(S100β) levels in patients undergoing gynecological laparoscopic hysterectomy.Methods A total of 78 patients with abdominal hysterectomy from May 2017 to September 2020 in our hospital were selected and randomly divided into three groups: group A,group B and group C,with 26 cases in each group.All three groups were given general anesthesia and ulinastatin, and 1.0 μg/kg dexmedetomidine was given at 10 minutes before anesthesia induction, and then DEX was pumped into groups A,B and C with 0.2,0.4,0.6 μg/(kg·h) respectively until the end of operation.The hemodynamic indexes [mean arterial pressure(MAP),heart rate(HR)],serum inflammatory factors [tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)] levels and serum NSE,S100β levels at 10 min before anesthesia induction(T0),1 min after tracheal intubation(T1),1 min after pneumoperitoneum(T2) and the end of the operation(T3),and perioperative adverse reactions were compared among the three groups.Results MAP of group A and B at T1 and T2 was significantly higher than that at T0(all P<0.05),MAP of group A at T3 was still significantly higher than that at T0(P<0.05),there was no significant difference in MAP of group B between T3 and T0(all P>0.05),there was no significant difference in MAP group C between T1-3 and T0(all P>0.05),MAP of group C was significantly lower than that of group A and group B at the same time point(P<0.05);HR of group A was significantly higher than that of control group at T1 and T2(all P<0.05),compared with that in the control group, HR in group B and C was significantly lower(P<0.05),there was no significant difference in HR in the three groups between T3 and T0(all P>0.05),at T1-3,HR in group B and C was significantly lower than that in group A(P<0.05),there was no significant difference between groups B and C(all P<0.05);at T1-3,the levels of TNF-�
作者
蒋迅
江涛
JIANG Xun;JIANG Tao(Department of Anesthesiology,the First People's Hospital of Jiujiang City,Jiujiang,Jiangxi 332000,China)
出处
《中国妇幼保健》
CAS
2022年第23期4331-4335,共5页
Maternal and Child Health Care of China
基金
江西省卫生计生委科技计划项目资助(2019712)。
