CAJ | 학술논문

目的：观察并评价右美托咪定（dexmedetomidine，Dex）对腹腔镜全子宫切除术患者氧化应激反应的影响。方法择期全麻行腹腔镜全子宫切除术患者40例，随机分为两组：D组（Dex组，n＝20），Dex静脉泵注负荷剂量为1μg·kg－1（15 min内输注完），然后以0．5μg·kg－1·h－1持续泵注至手术结束前30 min。C组（对照组，n＝20），同样方式输注生理盐水。于麻醉前（T0）、气腹结束即刻（T1）、气腹结束后30 min（T2）和术后24 h（T3）4个时间点记录平均动脉压（MAP）、心率（HR）并抽取静脉血，测定血清过氧化氢（H2 O2）、丙二醛（MDA）和总抗氧化态（TAS）浓度。结果与T0相比，C组MAP在T1、T2时间点差异有显著性（P＜0．05）。与T0相比，T1、T2时间点C组、D组H2O2、MDA增高，TAS降低（P＜0．05）。T3时D组H2O2、MDA与T0比较差异无显著性（P＞0．05），而C组仍较高（P＜0．05）；与C组相比，D组T2、T3时间点H2O2、MDA浓度低，TAS浓度高（P＜0．05）。两组在T1时间点H2O2、MDA差异无显著性（P＞0．05），但D组较C组TAS浓度高（P＜0．05）。结论右美托咪定可减轻腹腔镜全子宫切除术患者氧化应激反应。
목적：관찰병평개우미탁미정（dexmedetomidine，Dex）대복강경전자궁절제술환자양화응격반응적영향。방법택기전마행복강경전자궁절제술환자40례，수궤분위량조：D조（Dex조，n＝20），Dex정맥빙주부하제량위1μg·kg－1（15 min내수주완），연후이0．5μg·kg－1·h－1지속빙주지수술결속전30 min。C조（대조조，n＝20），동양방식수주생리염수。우마취전（T0）、기복결속즉각（T1）、기복결속후30 min（T2）화술후24 h（T3）4개시간점기록평균동맥압（MAP）、심솔（HR）병추취정맥혈，측정혈청과양화경（H2 O2）、병이철（MDA）화총항양화태（TAS）농도。결과여T0상비，C조MAP재T1、T2시간점차이유현저성（P＜0．05）。여T0상비，T1、T2시간점C조、D조H2O2、MDA증고，TAS강저（P＜0．05）。T3시D조H2O2、MDA여T0비교차이무현저성（P＞0．05），이C조잉교고（P＜0．05）；여C조상비，D조T2、T3시간점H2O2、MDA농도저，TAS농도고（P＜0．05）。량조재T1시간점H2O2、MDA차이무현저성（P＞0．05），단D조교C조TAS농도고（P＜0．05）。결론우미탁미정가감경복강경전자궁절제술환자양화응격반응。
Objective To observe and evaluate the effect of dexmedetomidine (Dex)on oxidative stress of patients with laparoscopic hysterectomy.Methods Forty patients with laparoscopichysterectomy were assigned into 2 groups randomly:D group(Dex ,n=20), dexmedetomidine infusion intravenous loading dose of 1 μg·kg-1 (infusion completed within 15 minutes),then 0.5 μg·kg-1 · h-1 continuous infusion to 30 min before the end of surgery;C group (The control group,n=20),infusion of saline in the same way.Re-cords mean arterial pressure(MAP)and heart rate (HR)and venous blood sample was taken at four time points:before anesthesia (T0 ),immediate end of pneumoperitoneum (T1 ),30 min after pneumoperitoneum (T2 )and 24 h (T3 ).Concentrations of hydrogen peroxide(H2 O2 ),malondialdehyde (MDA)and total antioxidant status (TAS)in plasma were determined.Results Compared with T0,Group C MAP at T1、T2 time difference was significant (P<0.05).Compared with T0,H2O2,MDA increased and TAS reduced in the two groups at T1,T2 (P<0.05).There was no significant difference between T0and T3in group D in H2O2,MDA(P>0.05), while H2 O2 ,MDA were still higher in group C (P<0.05 ).Compared with group C,group D had low MDA concentration and high TAS concentration at T2 ,T3 time points (P<0.05 ).There were no significant differences in H2 O2 and MDA at T2 between the two groups (P>0.05 ).However,group D,compared with group C,had a higher TAS concentration (P<0.05 ).Conclusion Dexme-detomidine can reduce oxidative stress of patients undergoing laparoscopic hysterectomy.