摘要
目的探讨右美托咪定联合地佐辛对乳腺癌手术患者血流动力学、炎性因子、应激反应及术后麻醉恢复的影响。方法将拟行乳腺癌根治术的90例患者按随机数字表法分为联合组、右美托咪定组、地佐辛组,各30例。3组均在气管插管全麻下行乳腺癌根治术治疗,在麻醉诱导前右美托咪定组予以右美托咪定镇痛镇静,地佐辛组予以地佐辛镇痛镇静,联合组予以右美托咪定联合地佐辛镇痛镇静。比较3组T0(术前)、T1(手术切皮)、T2(手术开始后1 h)、T3(术毕)时点血流动力学指标(平均动脉压、心率),T0、T3、T4(术后12 h)、T5(术后24 h)时点血清炎性因子指标(肿瘤坏死因子-α、白细胞介素-6、C反应蛋白)、应激反应指标(血管紧张素Ⅱ、皮质醇、醛固酮)、免疫功能指标(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))水平以及麻醉恢复情况、不良反应发生率。结果(1)血流动力学:联合组T1、T2、T3时点平均动脉压、心率与T0时点比较差异无统计学意义(P>0.05),均显著低于右美托咪定组、地佐辛组(P<0.05或0.01);右美托咪定组、地佐辛组T1、T2、T3时点平均动脉压、心率均较T0时点显著升高(P<0.05或0.01)。(2)炎性因子:3组T3、T4、T5时点血清肿瘤坏死因子-α、白细胞介素-6、C反应蛋白水平均较T0时点显著升高(P<0.05或0.01),联合组显著低于右美托咪定组、地佐辛组(P<0.01)。(3)应激反应:T3、T4时点3组血清血管紧张素Ⅱ、皮质醇、醛固酮水平较T0时显著增高(P<0.05或0.01),T5时点右美托咪定组、地佐辛组血清血管紧张素Ⅱ水平较T0时显著增高(P<0.01),联合组较T0时点无显著变化(P>0.05);T3、T4、T5时点联合组血清血管紧张素Ⅱ、皮质醇、醛固酮水平显著低于右美托咪定组、地佐辛组(P<0.05或0.01)。(4)免疫功能:3组T3、T4、T5时点血清CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平较T0时点显著降低(P<0.01),联合组显著高于右美托咪定组、地佐辛�
Objective To investigate the effects of dexmedetomidine(Dex)combined with dezocine(Dez)on hemodynamics,inflammatory factors,stress reaction and postoperative anesthesia recovery in breast cancer patients.Methods A total of 90 patients undergoing radical mastectomy for breast cancer were selected and divided into a combined group(n=30),a Dex group(n=30),and a Dez group(n=30)with a random number table.All groups were treated with endotracheal intubation for general anesthesia.The Dex group was given Dex before anesthesia induction,the Dez group was given Dez before anesthesia induction,and the combined group was given Dex combined with Dez.The hemodynamic indicators[mean arterial pressure(MAP),heart rate(HR)]before operation(T0),when the skin was cut(T1),1 h after the start of the operation(T2),and after the operation(T3),serum inflammatory factor indexes[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)],stress response indicators[angiotensinⅡ(AngⅡ),cortisol(Cor),aldosterone(ALD)],and immune function indicators(CD3^(+),CD4^(+),CD4^(+)/CD8^(+))levels at T0,T3,12 h after operation(T4),and 24 h after operation(T5),and the recovery of anesthesia and adverse reactions of the three groups were compared.Results(1)Hemodynamics:Compared with T0,there was no significant change in MAP and HR levels in T1,T2,T3 of the combined group(P>0.05),and were significantly lower than those in the Dex group and the Dez group(P<0.05 or 0.01).Compared with T0,MAP and HR at T1,T2,T3 in the Dex group and the Dez group were significantly increased(P<0.05 or 0.01).(2)Inflammatory factor:The levels of serum TNF-α,IL-6 and CRP in the three groups at T3,T4,T5 were significantly higher than those at T0(P<0.05 or 0.01).The combined group was significantly lower than the Dex group and the Dez group(P<0.01).(3)Stress response:Compared with T0,AngⅡ,Cor and ALD in the three groups at T3,T4 were significantly increased(P<0.05 or 0.01).Serum AngⅡin the Dex group and the Dez group was significantly increased at T5 comp
作者
谢星彤
梁龙
Xie Xingtong;Liang Long(The 16th People's Hospital of Zhengzhou,Dengfeng 452470,Henan,China)
出处
《临床心身疾病杂志》
CAS
2023年第1期13-21,共9页
Journal of Clinical Psychosomatic Diseases
关键词
乳腺癌根治术
气管插管
全麻
右美托咪定
地佐辛
血流动力学
炎性因子
应激反应
免疫功能
radical mastectomy for breast cancer
endotracheal intubation
general anesthesia
dexmedetomidine
dezocine
hemodynamics
inflammatory factor
stress response
immune function
