中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2014年
6期
674-676
,共3页
王东昕%阚红莉%于晓东%刘卓
王東昕%闞紅莉%于曉東%劉卓
왕동흔%감홍리%우효동%류탁
右美托咪啶%呼吸,人工%全身炎症反应综合征%呼吸功能试验
右美託咪啶%呼吸,人工%全身炎癥反應綜閤徵%呼吸功能試驗
우미탁미정%호흡,인공%전신염증반응종합정%호흡공능시험
Dexmedetomidine%Respiration,artificial%Systemic inflammatory response syndrome%Respiratory function tests
目的 评价右美托咪定对肺癌根治术患者单肺通气时的肺保护作用.方法 择期拟行肺癌根治术患者30例,性别不限,年龄40 ～ 70岁,体重50 ～ 80 kg,ASA分级Ⅰ-Ⅲ级.采用随机数字表法,将其分为2组(n=15):右美托咪定组(D组)和对照组(C组).D组于麻醉诱导前经10 min静脉输注右美托咪定负荷量1.0 μg/kg,随后以0.6 μg·kg-1 ·h-1速率静脉输注至关胸.C组给予等容量生理盐水.于麻醉诱导后即刻(T1)、单肺通气30 min (T2)、60 min (T3)、术毕(T4)时分别采集动脉血,采用ELISA法测定血清TNF-α、IL-6及IL-8的浓度,并行动脉血气分析,计算氧合指数.结果 与C组比较,D组血清TNF-α、IL-6和IL-8浓度降低,氧合指数升高(P＜0.05).结论 右美托咪定可减轻肺癌根治术患者单肺通气期间肺组织炎性反应,改善肺功能,产生肺保护作用.
目的 評價右美託咪定對肺癌根治術患者單肺通氣時的肺保護作用.方法 擇期擬行肺癌根治術患者30例,性彆不限,年齡40 ～ 70歲,體重50 ～ 80 kg,ASA分級Ⅰ-Ⅲ級.採用隨機數字錶法,將其分為2組(n=15):右美託咪定組(D組)和對照組(C組).D組于痳醉誘導前經10 min靜脈輸註右美託咪定負荷量1.0 μg/kg,隨後以0.6 μg·kg-1 ·h-1速率靜脈輸註至關胸.C組給予等容量生理鹽水.于痳醉誘導後即刻(T1)、單肺通氣30 min (T2)、60 min (T3)、術畢(T4)時分彆採集動脈血,採用ELISA法測定血清TNF-α、IL-6及IL-8的濃度,併行動脈血氣分析,計算氧閤指數.結果 與C組比較,D組血清TNF-α、IL-6和IL-8濃度降低,氧閤指數升高(P＜0.05).結論 右美託咪定可減輕肺癌根治術患者單肺通氣期間肺組織炎性反應,改善肺功能,產生肺保護作用.
목적 평개우미탁미정대폐암근치술환자단폐통기시적폐보호작용.방법 택기의행폐암근치술환자30례,성별불한,년령40 ～ 70세,체중50 ～ 80 kg,ASA분급Ⅰ-Ⅲ급.채용수궤수자표법,장기분위2조(n=15):우미탁미정조(D조)화대조조(C조).D조우마취유도전경10 min정맥수주우미탁미정부하량1.0 μg/kg,수후이0.6 μg·kg-1 ·h-1속솔정맥수주지관흉.C조급여등용량생리염수.우마취유도후즉각(T1)、단폐통기30 min (T2)、60 min (T3)、술필(T4)시분별채집동맥혈,채용ELISA법측정혈청TNF-α、IL-6급IL-8적농도,병행동맥혈기분석,계산양합지수.결과 여C조비교,D조혈청TNF-α、IL-6화IL-8농도강저,양합지수승고(P＜0.05).결론 우미탁미정가감경폐암근치술환자단폐통기기간폐조직염성반응,개선폐공능,산생폐보호작용.
Objective To evaluate the pulmonary protection of dexmedetomidine during one-lung ventilation in patients undergoing radical operation for lung cancer.Methods Thirty patients of both sexes,aged 40-70 yr,weighing 50-80 kg,of ASA physical status Ⅰ-Ⅲ,scheduled for elective radical operation for lung cancer,were randomized into 2 groups (n =15 each):dexmedetomidine group (group D) and control group (group C).Before induction of anesthesia,a loading dose of dexmedetomidine 1.0 μg/kg was infused over 10 min,followed by continuous infusion of dexmedetomidine at a rate of 0.6 μg· kg-1 · h-1 until the chest was closed in group D,while the equal volume of normal saline was given in group C.Immediately after induction of anesthesia,at 30 and 60 min of one-lung ventilation,and at the end of operation,arterial blood samples were collected for determination of the serum concentrations of TNF-α,IL-6 and IL-8,and for blood gas analysis.Oxygenation index was calculated.Results Compared with group C,the serum concentrations of TNF-α,IL-6 and IL-8 were significantly decreased,and oxygenation index was increased in group D.Conclusion Dexmedetomidine can mitigate inflammatory responses during one-lung ventilation and improve pulmonary function,thus providing pulmonary protection in patients undergoing radical operation for lung cancer.
