中华实验外科杂志
中華實驗外科雜誌
중화실험외과잡지
CHINESE JOURNAL OF EXPERIMENTAL SURGERY
2012年
11期
2304-2306
,共3页
右美托咪定%食管癌根治术%单肺通气%肿瘤坏死因子-α%白细胞介素-6
右美託咪定%食管癌根治術%單肺通氣%腫瘤壞死因子-α%白細胞介素-6
우미탁미정%식관암근치술%단폐통기%종류배사인자-α%백세포개소-6
Dexmedetomidine%Radical esophagectomy%One-lung ventilation%Tumor necrosis factor-α%Interleukin-6
目的 观察右美托咪定对食管癌根治术单肺通气患者血浆肿瘤坏死因子(TNF)-α和白细胞介素(IL)-6水平的影响.方法 60例拟行食管癌根治术的患者,随机分为D1组、D2组和C组,每组20例.D1组麻醉诱导前0.6μg/kg静脉泵注右美托咪定；D2组麻醉诱导后以0.3μg/(kg·h)静脉泵注右美托咪定；C组为对照组.分别测定麻醉诱导前20 min(T0),气管插管后10 min(T1),单肺通气30 min(T2),单肺通气90 min(T3)及再次双肺通气后10 min(T4)5个时间点血浆中TNF-α和IL-6浓度.结果 3组患者血浆TNF-α水平在T3、T4时点较T0高(P ＜0.05)；D1组和D2组在T3(10.5±2.5,11.1 ±2.6)、T4(11.2±2.4,11.8±2.7)时点较C组增高(P＜0.05).3组患者血浆IL-6水平在T4时点较T0高(P ＜0.05)；D1组和D2组在T4时点(23.2±3.3,23.9±3.2)较C组增高(P＜0.05).结论 术前静脉泵注0.6 μg/kg及术中持续以0.3μg,/(kg·h)静脉泵注右美托咪定均能抑制食管癌根治术单肺通气患者血浆中TNF-α和IL-6水平升高.
目的 觀察右美託咪定對食管癌根治術單肺通氣患者血漿腫瘤壞死因子(TNF)-α和白細胞介素(IL)-6水平的影響.方法 60例擬行食管癌根治術的患者,隨機分為D1組、D2組和C組,每組20例.D1組痳醉誘導前0.6μg/kg靜脈泵註右美託咪定；D2組痳醉誘導後以0.3μg/(kg·h)靜脈泵註右美託咪定；C組為對照組.分彆測定痳醉誘導前20 min(T0),氣管插管後10 min(T1),單肺通氣30 min(T2),單肺通氣90 min(T3)及再次雙肺通氣後10 min(T4)5箇時間點血漿中TNF-α和IL-6濃度.結果 3組患者血漿TNF-α水平在T3、T4時點較T0高(P ＜0.05)；D1組和D2組在T3(10.5±2.5,11.1 ±2.6)、T4(11.2±2.4,11.8±2.7)時點較C組增高(P＜0.05).3組患者血漿IL-6水平在T4時點較T0高(P ＜0.05)；D1組和D2組在T4時點(23.2±3.3,23.9±3.2)較C組增高(P＜0.05).結論 術前靜脈泵註0.6 μg/kg及術中持續以0.3μg,/(kg·h)靜脈泵註右美託咪定均能抑製食管癌根治術單肺通氣患者血漿中TNF-α和IL-6水平升高.
목적 관찰우미탁미정대식관암근치술단폐통기환자혈장종류배사인자(TNF)-α화백세포개소(IL)-6수평적영향.방법 60례의행식관암근치술적환자,수궤분위D1조、D2조화C조,매조20례.D1조마취유도전0.6μg/kg정맥빙주우미탁미정；D2조마취유도후이0.3μg/(kg·h)정맥빙주우미탁미정；C조위대조조.분별측정마취유도전20 min(T0),기관삽관후10 min(T1),단폐통기30 min(T2),단폐통기90 min(T3)급재차쌍폐통기후10 min(T4)5개시간점혈장중TNF-α화IL-6농도.결과 3조환자혈장TNF-α수평재T3、T4시점교T0고(P ＜0.05)；D1조화D2조재T3(10.5±2.5,11.1 ±2.6)、T4(11.2±2.4,11.8±2.7)시점교C조증고(P＜0.05).3조환자혈장IL-6수평재T4시점교T0고(P ＜0.05)；D1조화D2조재T4시점(23.2±3.3,23.9±3.2)교C조증고(P＜0.05).결론 술전정맥빙주0.6 μg/kg급술중지속이0.3μg,/(kg·h)정맥빙주우미탁미정균능억제식관암근치술단폐통기환자혈장중TNF-α화IL-6수평승고.
Objective To observe the changes in plasma concentrations of tumor necrosis factor (TNF)-α and interleukin (IL)-6 in patients undergoing radical esophagectomy during one-lung ventilation.Methods Sixty patients undergoing open radical esophagectomy were randomly divided into three groups:group D1 was given dexmedetomidine intravenously at 0.6 μg/kg 20 min before induction of anesthesia; group D2 was given dexmedetomidine intravenously at 0.3 μg/(kg· h) after induction of anesthesia; group C served as control group.The plasma concentrations of TNF-α and IL-6 were measured by using enzyme linked immunosorbent assay (ELISA) at 20 min betore anesthesia induction (T0),10 min after tracheal intubation (T1),30 min after one-lung ventilation (T2),90 min after one-lung ventilation (T3) and 10 min after resuming two-lung ventilation (T4).Results As compared with T0,plasma TNF-α concentration was increased critically at T3 and T4 in three groups.Plasma TNF-α concentrations in groups D1 and D2 at T3 (10.5 ± 2.5,and 11.1 ± 2.6) and T4 (11.2 ± 2.4,and 11.8 ± 2.7) were lower than that in group C.Plasma IL-6 concentration was higher at T4 than that at T0.Plasma IL-6 concentration in group D1 (23.2 ±3.3) and group D2 (23.9 ±3.2) at T4 was lower than that in group C.Conclusion A single bolus dose of 0.6 μg/kg dexmedetomidine before induction of anesthesia could inhibit the production of plasma TNF-α and IL-6 in the patients undergoing radical esophagectomy with one-lung ventilation.So was the continuous infusion dose of 0.3 μg/(kg· h) dexmedetomidine.
