摘要
目的 探讨术前静脉泵入右美托咪定对子宫切除术患者应激反应与炎症反应的影响.方法 选择2014年10月～2016年10月在金华市中医医院行子宫切除术的96 例患者,通过随机数表法分为观察组(n =48)和对照组(n =48).2 组均采用全凭静脉麻醉,观察组在麻醉前给予1 μg/kg 右美托咪定的静脉泵注,在15 min 内泵注完毕,之后以0.5 μg/kg/h 的速度持续泵注,直至手术结束前30 min;对照组给予同样的方式输注生理盐水.记录手术时间、术中出血量、苏醒时间、拔管时间、住院时间;并在T0(麻醉前)、T1(气腹结束时)、T2(气腹结束后30 min)、T3(术后24 h)4 个时间点记录平均动脉压(MAP)、心率(HR)、过氧化氢(H2 O2)、丙二醛(MDA)、总抗氧化态(TAS)、肿瘤坏死因子(TNF)-α、干扰素(IFN)-γ、白介素(IL)-10 的变化.结果 2 组手术时间、术中出血量、苏醒时间、拔管时间、住院时间比较均无明显差异;对照组MAP 在T1 时点显著降低,T2 时点明显升高,HR 在T1 时点显著降低( P< 0.05),观察组MAP、HR水平在各时点均无显著变化;观察组在T1、T2、T3时点H2O2、MDA均低于对照组,TAS高于对照组( P< 0.05);观察组在T1、T2、T3时点TNF-α、IFN-γ、IL-10均低于对照组( P< 0.05).结论 在子宫切除术患者麻醉前给予右美托咪定的静脉泵入,有利于保持患者血流动力学稳定,并有效缓解应激反应、炎症反应,值得推广.
Abstract
Objective To study the effect of dexmedetomidine on stress response and inflammatory reaction of patients with hysterectomy.Methods 96 patients with hysterectomy who received therapy from October 2014 to October 2016 in Jinhua traditional Chinese medicine hospital were selected.According to random number table,those patients were divided into the observation group(n=48)and the control group(n=48).Two groups were treated with total intravenous anesthesia,the observation group was treated with intravenous infusion of dexmedetomidine1μg·kg-1 before anesthesia,pump is completed within 15 minutes,then continuous injection of 0.5μg·kg-1·h-1 speed to the 30min before the end of the operation; the control group was given the same way of infusion of normal saline.The operation time,blood loss,recovery time,extubation time and length of stay were recorded,and the hanges of mean arterial pressure(MAP),heart rate(HR),hydrogen peroxide(H2O2),malondialdehyde(MDA),total antioxidant status(TAS),tumor necrosis factor(TNF)-α,interferon(IFN)-γ,interleukin(IL)-10 at T0(before anesthesia),T1(at the end of pneumoperitoneum),T2(after the end of pneumoperitoneum 30min),T3(postoperative 24h)were recorded.Results There was no significant difference between the two groups in operation time,blood loss,recovery time,extubation time and length of stay; in the control group,the MAP was significantly reduce at T1,T2 was significantly higher,the HR was significantly reduce at T1(P<0.05); there was no significant change of MAP and HR levels in the observation group at each time point; the H2O2 and MDA in the observation group were lower than that of the control group at T1,T2 and T3,and the TAS was higher than that of the control group(P<0.05); the TNF-α,IFN-γ and IL-10 in the observation group were lower than that of the control group at T1,T2 and T3(P<0.05).Conclusion Intravenous infusion of dexmedetomidine before anesthesia is well for patients with hysterectomy,it'is helpful to maintain the hemodynamic stability,and effectively alleviate the stress response,inflammation reaction,it's worth promoting.
NETL
NSTL
维普
万方数据