[1]李沛函,韩雪萍#,孙政,等.盐酸右旋美托咪定对食管癌根治术患者围术期肺功能及炎性反应的影响[J].郑州大学学报(医学版),2013,(04):540.
 LI Peihan,HAN Xueping,SUN Zheng,et al.Effects of dexmedetomidine on pulmonary function and inflammatory response during perioperative period in patients undergoing radical esophagectomy[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2013,(04):540.
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盐酸右旋美托咪定对食管癌根治术患者围术期肺功能及炎性反应的影响
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2013年04期
页码:
540
栏目:
应用研究
出版日期:
2013-07-20

文章信息/Info

Title:
Effects of dexmedetomidine on pulmonary function and inflammatory response during perioperative period in patients undergoing radical esophagectomy
作者:
李沛函韩雪萍#孙政王海涛康鑫鑫
郑州大学第一附属医院麻醉科 郑州 450052
Author(s):
LI PeihanHAN XuepingSUN ZhengWANG HaitaoKANG Xinxin
Department of Anesthesiology,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052
关键词:
盐酸右旋美托咪定呼吸功能试验炎症食管癌根治术
Keywords:
dexmedetomidinepulmonary functioninflammatory responseradical esophagectomy
分类号:
R614.2+4
摘要:
目的:探讨盐酸右旋美托咪定对食管癌根治术患者围术期肺功能及炎症反应的影响。方法:选择择期行食管癌根治术的ASAⅠ~Ⅱ级患者60例,分为对照组(C组)、D1组和D2组(每组20例)。3组患者均采用相同的麻醉方法。麻醉诱导后D1组和D2组分别以0.3和0.5 μg/(kg·h)静脉泵入盐酸右旋美托咪定,手术结束前30 min停止;C组不做处理。分别于麻醉诱导前(T0)、单肺通气前(T1)、单肺通气后(T2)、关胸(T3)、术后24 h(T4)测定动脉血压分压,并计算肺泡动脉氧分压差和呼吸指数;于T1、T2、T3时计算肺有效顺应性;于T0、T3、T4时检测血浆肿瘤坏死因子α(TNFα)和人肺表面活性特异蛋白D(SPD)。结果:与T0时比较,T1~ T3时3组的动脉血氧分压、肺泡动脉氧分压差均升高(P<0.05);与T1比较,T3时C组气道平台压、气道峰压均升高(P<0.05)。与C组相比,D1组和D2组在T3时TNFα和SPD的含量降低,其中D2组降低幅度小于D1组(P<0.05)。结论:盐酸右旋美托咪定能够抑制食管癌根治术患者围术期炎性反应,并改善肺功能。
Abstract:
Aim: To investigate the effects of dexmedetomidine on pulmonary function and inflammatory response during perioperative period in the patients undergoing radical esophagectomy. Methods:Sixty ASAⅠor Ⅱ patients scheduled for radical esophagectomy were randomly divided into 3 groups(20 in each group): control group(group C), low dose dexmedetomidine group(group D1) and high dose dexmedetomidine group(group D2). The same standard anesthesia protocol was used for induction and maintainence in all 3 groups. After induction, dexmedetomidine was infused at rate of 0.3 μg/(kg·h) (group D1) and 0.5 μg/(kg·h) (group D2) until 30 min before the end of operation. Group C received the equal volume of normal saline. Arterial blood samples were collected for blood gas analysis before induction of anesthesia(T0),before OLV(T1),at the end of OLV(T2),when the chest was closed(T3)and at 24 h after operation(T4). p(Aa)O2 and respiratory index (RI) were calculated. Plasma TNFα and SPD were measured at T0, T3 and T4. Dynamic lung compliance(Cd) was calculated at T1,T2 and T3.Results: paO2,p(Aa)O2 at T1,T2, T3 and plasma TNFα, SPD concentrations at T3 were significantly increased as compared with the baseline values at T0 in all 3 groups.The airway platform pressure and peak pressure was significantly raised at T3 than T1 in all 3 groups. Plasma TNFα and SPD concentrations at T3 decreased in group D1 and D2 than those in group C, and the changes in group D2 was lower than those in group D1. Conclusion: Dexmedetomidine can improve the lung function and prohibit inflammatory response of patients undergoing radical esophagectomy.

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备注/Memo

备注/Memo:
#通讯作者,女,1958年12月生,硕士,主任医师,教授,研究方向:疼痛诊疗、麻醉期间器官保护等,Email:hanxueping66@sina.com
更新日期/Last Update: 2013-07-25