摘要
目的:探讨右美托咪啶对全身麻醉下肺癌微创手术患者非通气侧肺脏损伤的影响。方法:54例肺癌患者随机分为右美托咪啶组与对照组,每组27例。右美托咪啶组于麻醉诱导前10min以1μg/kg的剂量静脉泵注盐酸右美托咪啶,后以0.5μg/(kg·h)输注速率输注至肺肿瘤切除后即刻;对照组以同样的方法静脉输注等量的生理盐水。所有患者均于单肺通气即刻(Ta)、单肺通气1h(Tb)、单肺通气结束即刻(Tc)对肺损伤情况、血红素加氧酶-1(HO-1)与缺氧诱导因子-1α(HIF-1α)进行评估。结果:与Ta时相比,两组Tc时非通气侧肺脏损伤评分、HO-1、HIF-1α均明显升高;Tc时,右美托咪啶组非通气侧肺脏损伤评分显著低于对照组,HO-1、HIF-1α显著高于对照组。结论:右美托咪啶可以降低全身麻醉下肺癌微创手术患者非通气侧肺脏损伤,作用机制可能与HO-1、HIF-1α有关。
Objective:To explore the effect of dexmedetomidine on the injury of non ventilated lung in patients of lung cancer with minimally invasive surgery under general anesthesia.Methods:Fifty-four patients with lung cancer were randomly divided into dexmedetomidine group and control group,27 cases in each group.1μg/kg dexmedetomidine hydrochloride were given by venous pump to patients in dexmedetomidine group 10 min before induction of anesthesia and kept at the 0.5g/(kg·h)transmission rate until the tumors were excised.The same volume of physiological saline was given to control group by venous pump.Lung injury,heme oxygenase 1(HO-1)and hypoxia inducible factor 1α(HIF-1α)were evaluated in all patients at the beginning(Ta),1hour later(Tb)and the end(Tc)of single lung ventilation.Results:Injury scores of the non-ventilated lung in both of the two groups were higher at the Tc than at the Ta.Injury scores of the non-ventilated lung at the Tc were lower in dexmedetomidine group than in control group.HO-1and HIF-1αof the non-ventilated lung in both of the two groups were higher at the Tc than at the Ta.HO-1and HIF-1αof the non-ventilated lung at the Tc were higher in dexmedetomidine group than in control group.Conclusion:Dexmedetomidine can reduce injury of the non-ventilated lung in systemic anesthesia patients with minimally invasive surgery for lung cancer.HO-1and HIF-1αmay be involved in this course.
出处
《西北国防医学杂志》
CAS
2016年第10期653-656,共4页
Medical Journal of National Defending Forces in Northwest China
关键词
麻醉学
右美托咪啶
肺癌
微创
anesthesiology
dexmedetomidine
lung cancer
minimally invasive
