|
| 右美托咪定可减轻肺叶切除术中单肺通气所致肺损伤 |
| The protective effects of dexmedetomidine on lung injury during one lung ventilation in patients undergoing lobectomia pulmonalis |
| |
| DOI：10.12089/jca.2017.12.1171 |
| 中文关键词: 右美托咪定 肺叶切除术 单肺通气 |
| 英文关键词: Dexmedetomidine Lobectomia pulmonalis One lung ventilation |
| 基金项目: |
|
| 摘要点击次数: 2575 |
| 全文下载次数: 1121 |
| 中文摘要: |
目的 探讨右美托咪定对肺叶切除术中单肺通气所致肺损伤的影响。
方法 选择2014年5月至2017年2月拟行肺叶切除术的肺癌患者64例, 男38例, 女26例, 年龄42～75岁, ASA Ⅱ或Ⅲ级。根据不同治疗方式将患者分成两组, 每组32例。麻醉诱导前20 min, 观察组泵注右美托咪定0.5 μg·kg-1·h-1, 10 min后改为0.2～0.5 μg·kg-1·h-1, 对照组予以等容量生理盐水。检测麻醉诱导前10 min(T0)、单肺通气即刻(T1)、单肺通气60 min(T2)、单肺通气90 min(T3)、术后24 h(T4)的全血中性粒细胞(PMN)计数, 血清髓过氧化物酶(MPO)、黄嘌呤氧化酶(XOD)活性, 肺内分流率(Qs/Qt), 以及T0～T3时血管内皮生长因子(VEGF)和一氧化氮(NO)浓度。
结果 与T0时比较, T2～T4时两组PMN计数明显增多, MPO和XOD活性明显升高(P<0.05), 但观察组明显低于对照组(P<0.05)。与T0时比较, T2、T3时两组血清VEGF浓度明显升高,但T3时观察组明显低于对照组(P<0.05)。T2、T3时观察组血清NO浓度明显高于对照组(P<0.05)。
结论 右美托咪定能减少患者肺部炎症反应, 减轻单肺通气所致缺血 再灌注损伤,且降低了患者机体氧化应激程度, 从而对肺起到保护作用。 |
| 英文摘要: |
Objective To investigate the protective effects of dexmedetomidine on lung injury during one lung ventilation in patients undergoing lobectomia pulmonalis.
Methods Sixty-four patients undergoing lobectomy in our hospital from May 2014 to February 2017 were selected. There were 38 males and 26 females, aged 42-75 years, ASA physical status Ⅱ or Ⅲ. Patients were divided into two groups according to different treatments, n=32 in each group. The patients in the observation group were given dexmedetomidine 0.5 μg·kg-1·h-1 at 20 min before the induction of anesthesia, and adjusted to 0.2-0.5 μg·kg-1·h-1 after 10 min. The control group was given equal volume normal saline. The changes of polymorphonuclear neutrophil (PMN), myeloper oxidase (MPO), intra-pulmonary shunt rate (Qs/Qt), xanthine oxidase (XOD), vascular endothelial growth factor (VEGF) and nitric oxide (NO) concentration were recorded at 10 min before induction (T0), beginning of OLV (T1), OLV for 60 min (T2), 90 min (T3), postoperative 24 h (T4).
Results Compared with T0, the PMN counts increased significantly at T2-T4 and the serum MPO and XOD concentrations were significantly increased (P<0.05). The PMN counts, serum MPO and XOD concentration in the observation group were significantly lower than those in the control group (P<0.05). Compared with T0, the serum VEGF concentration was significantly increased at T2 and T3, and the serum VEGF concentration in the observation group was significantly lower than that in control group at T3 (P<0.05). The serum NO concentration at T2 and T3 in observation group was significantly higher than that in control group (P<0.05).
Conclusion Dexmedetomidine can reduce the inflammatory response of the lungs and has a protective effect on ischemia-reperfusion and injury in patients with single lung ventilation, and reduce the degree of oxidative stress, which plays a protective effect on lung. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
