| 摘要: |
| ［摘要］ 目的 评价右美托咪定对腹腔镜胃癌根治术患者术后肺功能及应激反应的影响。方法 选择2015-06～2017-11该院收治的行腹腔镜胃癌根治术患者80例,采用随机数字表法分为对照组(C组)和右美托咪定组(Dex组)，每组40例。均采用全麻联合硬膜外麻醉。硬膜外穿刺置管后全麻诱导前,Dex组经10 min静脉输注右美托咪定0.3 μg/kg,气管插管术后以0.4 μg/（kg·h）的速率静脉输注至手术结束前30 min；C组给予等容量生理盐水。于硬膜外置管后右美托咪定输注前(T0)、关气腹前即刻(T1)与术后1、6、24 h时(T2～T4)采集外周静脉血,测定血清白细胞介素6（IL-6）、白细胞介素10（IL-10）、肿瘤坏死因子α（TNF-α）和丙二醛(MDA)浓度,同时行动脉血气分析,计算呼吸指数(RI)和氧合指数(OI),记录OI≤300 mmHg的发生情况。结果 与C组比较,Dex组在T1～T4时血清IL-6和TNF-α浓度及RI降低,IL-10浓度及OI升高（P<0.05）；在T1～T3时与C组比较，MDA浓度降低,OI≤300 mmHg发生率降低(P<0.05)。结论 右美托咪定可抑制腹腔镜胃癌根治术患者的炎症反应,改善术后肺功能。 |
| 关键词: 右美托咪定 人工气腹 呼吸功能试验 手术后并发症 |
| DOI：10.3969/j.issn.1674-3806.2018.07.11 |
| 分类号:R 614 |
| 基金项目: |
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| Effect of dexmedetomidine on postoperative pulmonary function and stress response in patients undergoing laparoscopic radical gastrectomy |
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WANG Jun-liang, HAN Mei
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Department of Anesthesiology, the Second People′s Hospital of Shenzhen City, Guangdong 518000, China
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| Abstract: |
| ［Abstract］ Objective To evaluate the effect of dexmedetomidine on postoperative lung function and stress response in patients undergoing laparoscopic radical gastrectomy. Methods Eighty patients undergoing laparoscopic radical gastrectomy for gastric cancer in our hospital from June 2015 to November 2017 were randomly divided into control group(group C) and dexmedetomidine group(Dex group), with 40 cases in each group. Both of the two groups received general anesthesia combined with epidural anesthesia. Before general anesthesia induction but after epidural catheterization, Dex group was given an intravenous infusion of dexmedetomidine 0.3 μg/kg for 10 min and an intravenous infusion rate of 0.4 μg/(kg·h) after tracheal intubation until 30 minutes before the end of surgery, and C group was given equal volume of saline. Peripheral venous blood was collected before dexmedetomidine infusion(T0), immediately before ventilation(T1) and at 1, 6, and 24 hours after the epidural catheter(T2 to T4). Interleukin 6(IL-6), interleukin 10(IL-10), tumor necrosis factor-α(TNF-α), and malondialdehyde(MDA) concentration were detected. At the same time, arterial blood gas analysis was performed to calculate the respiratory index(RI) and oxygenation index(OI), and the occurrence of OI≤300 mmHg was recorded. Results Compared with those in C group, the levels of serum IL-6 and TNF-α and RI were decreased, but IL-10 concentration and OI were increased in Dex group at T1～T4(P<0.05). Compared with those in C group, the MDA concentration was decreased and the incidence of OI≤300 mmHg was decreased in Dex group at T1～T3(P<0.05). Conclusion Dexmedetomidine can inhibit inflammation in the patients undergoing laparoscopic surgery and improve their postoperative pulmonary function. |
| Key words: Dexmedetomidine Artificial pneumoperitoneum Respiratory function test Postoperative complications |
