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| 右美托咪定对单肺通气患者动脉血气和炎性因子的影响 |
| Influence of dexmedetomidine on arterial blood gas and inflammation cytokines in patients with one-lung ventilation |
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| DOI： |
| 中文关键词: 右美托咪定 单肺通气 血气分析 炎性因子 |
| 英文关键词: Dexmedetomidine One-lung ventilation Blood gas analysis Inflammatory cytokines |
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| 中文摘要: |
目的：探讨右美托咪定对单肺通气(OLV)患者动脉血气和炎性因子的影响。
方法：选择择期肺癌根治术患者62例,性别不限，年龄34～69岁，ASA Ⅰ或Ⅱ级。按照收治先后顺序分成观察组和对照组, 每组31例。所有患者静脉注射舒芬太尼0.3～0.5 μg/kg、丙泊酚1.5～2.5 mg/kg、咪达唑仑0.5 mg/kg、罗库溴铵0.9 mg/kg行麻醉诱导;静脉输注丙泊酚6～8 mg·kg-1·h-1、瑞芬太尼0.1～0.5 μg·kg-1·min-1, 间断静脉注射顺式阿曲库铵进行麻醉维持。观察组患者于麻醉诱导前10 min静脉输注右美托咪定1.0 g/kg, 10 min输注完, 之后维持0.5 μg·kg-1·h-1速率输注至手术结束前30 min。对照组则输注等量的生理盐水。分别于OLV前即刻(T0)、OLV 1 h后(T1)、OLV结束时(T2)采集桡动脉血，检测血气（pH、PaO2、PaCO2）和炎性因子(TNF-α和IL-6)。记录两组手术结束后丙泊酚用量。
结果：与T0时比较, T1、T2时两组pH、 PaO2明显降低, PaCO2明显升高,TNF-α和IL-6含量明显升高(P<0.05)；T1、T2时观察组PaO2明显高于对照组(P<0.05), PaCO2明显低于对照组(P<0.05),TNF-α和IL-6含量明显低于对照组(P<0.05)。两组围术期顺式阿曲库铵用量和瑞芬太尼用量差异无统计学意义, 观察组丙泊酚用量明显低于对照组(P<0.05)。
结论：右美托咪定有助于维持单肺通气患者术中血气稳定, 减轻单肺通气引起的炎症反应。 |
| 英文摘要: |
Objective: To explore the influence of dexmedetomidine on blood gas and inflammation cytokines in patients with one-lung ventilation (OLV).
Methods: Sixty-two patients undergoing radical resection of pulmonary carcinoma were divided into observation group and control group in sequence, 31 cases in each group. All patients treated with intravenous sufentanil 0.3-0.5 μg/kg, propofol 1.5-2.5 mg/kg, midazolam 0.5 mg/kg and rocuronium 0.9 mg/kg for induction of anesthesia; intravenous infusion of propofol 6-8 mg·kg-1·h-1 and remifentanil 0.1-0.5 μg·kg-1·min-1, intermittent intravenous injection of cisatracurium for anesthesia maintenance. The patients in the observation group were given 1μg/kg loading dose dexmedetomidine 10 min before anesthesia induction (infusion in 10 min), maintaining at 0.5 μg·kg-1·h-1 until 30 min before the end of surgery. The patients in the control group were given the same amount of saline as a control. The blood gas analysis index, pH, partial oxygen pressure (PaO2), CO2 partial pressure (PaCO2) and such inflammation cytokines as tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) at OLV (T0), after OLV1h (T1), the end of OLV (T2) were respectively tested, the dosage of propofol in the two groups were recorded.
Results: The dosage of propofol in observation group was significantly lower than that in the control group (P<0.05); pH declined in the two groups (P<0.05), but the difference had no statistical significance; PaO2 was rising then declined in the two groups (P<0.05), but it was significantly higher in the observation group than in the control group(P<0.05); PaCO2 in the two groups increased gradually(P<0.05), it was significantly lower in the observation group than in the control group (P<0.05); The serum TNF-α, IL-6 in the two groups showed a trend of increasing (P<0.05), it was significantly lower in the observation group than in the control group (P<0.05).
Conclusion: Dexmedetomidine can maintain blood gas stability and reduce inflammation caused by single lung ventilation. |
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