CAJ | 학술논문

目的：探讨右美托咪定对体外循环下心内直视手术患者术后肺损伤的保护作用。方法收集我院60例心脏手术患者病例,随机分为两组,每组30例。观察组患者麻醉诱导前给予右美托咪定负荷量1．0μg/kg,维持量0．7μg/( kg·h)至手术结束,对照组不做处理。对两组患者T0(给药前)、T1(转流前)、T2(停机后1 h)、T3(停机后4 h)、T4(停机后24 h)的TNF-α、IL-1β、IL-6水平和肺泡动脉氧分压差( AaDO2)、氧合指数(OI)、呼吸指数(RI)进行对比分析。结果两组中,与T0点比较,T1~T4点TNF-α、IL-1β、IL-6呈现先增大后减小的趋势,两组各点比较差异有统计学意义( P<0．05)；而观察组各时间点TNF-α、IL-1β、IL-6水平显著性低于对照组(P<0．05)。两组中,与T0点比较,T1~T3点AaDO2、RI均升高(P<0．05),OI指数降低(P<0．05)；观察组各时间点AaDO2、OI、RI低于对照组(P<0．05)。结论右美托咪定能有效抑制体外循环下心内直视手术患者术后炎症反应,促进修复肺损伤。
목적：탐토우미탁미정대체외순배하심내직시수술환자술후폐손상적보호작용。방법수집아원60례심장수술환자병례,수궤분위량조,매조30례。관찰조환자마취유도전급여우미탁미정부하량1．0μg/kg,유지량0．7μg/( kg·h)지수술결속,대조조불주처리。대량조환자T0(급약전)、T1(전류전)、T2(정궤후1 h)、T3(정궤후4 h)、T4(정궤후24 h)적TNF-α、IL-1β、IL-6수평화폐포동맥양분압차( AaDO2)、양합지수(OI)、호흡지수(RI)진행대비분석。결과량조중,여T0점비교,T1~T4점TNF-α、IL-1β、IL-6정현선증대후감소적추세,량조각점비교차이유통계학의의( P<0．05)；이관찰조각시간점TNF-α、IL-1β、IL-6수평현저성저우대조조(P<0．05)。량조중,여T0점비교,T1~T3점AaDO2、RI균승고(P<0．05),OI지수강저(P<0．05)；관찰조각시간점AaDO2、OI、RI저우대조조(P<0．05)。결론우미탁미정능유효억제체외순배하심내직시수술환자술후염증반응,촉진수복폐손상。
Objective To research the protective effect of dexmedetomidine on lung injury after cardiac sur-gery under cardiopulmonary bypass. Methods 60 cases of cardiac surgery patients in our hospital were selected and randomly divided into two groups, each 30 cases. The observation group was given 0. 7μg/(kgoh) dexmedetomidine after anesthesia at the end of surgery, and the control group was not given any treatment. The levels of TNF-α, IL-1βand IL-6 and alveolar-arterial oxygen difference (AaDO2), oxygenation index (OI), respiratory index (RI) of the two groups were detected at T0(before administration), T1(before CPB), T2(after the shutdown 1h), T3(after stop-ping 4h), and T4(after stopping 24h). Results The levels of TNF-α, IL-1βand IL-6 of the two groups at T1 ~T4 point showed a decreasing trend after the first increases, and the difference was statistically significant at each point (P<0. 05). The levels of TNF-α, IL-1βand IL-6 were significantly lower in the observation group than in the con-trol group ( P<0. 05 ) . The value of AaDO2 and RI of the two groups at T1 ~T3 showed a increasing trend ( P<0. 05), and the value of OI of the two groups at T1 ~T3 showed a decreasing trend. The values of AaDO2, OI and RI were significantly lower in the observation group than in the control group (P<0. 05). Conclusion Dexmedetomi-dine can effectively inhibit inflammation and repair lung injury of heart surgery patients with cardiopulmonary bypass.