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目的观察全麻期间持续应用盐酸右美托咪定对食管癌根治术患者围术期血糖、β-内啡肽(β-EP)、肿瘤坏死因子α(TNF-α)和白细胞介素6(IL-6)表达水平的影响。方法 40例择期行食管癌根治术的患者,所有患者均采用全凭静脉麻醉,随机分为盐酸右美托咪定组和对照组(n=20)。两组分别于麻醉诱导前(T0)、拔管(T1)即刻、术后ld(T2)和术后2d(T3)晨抽取静脉血,测定血糖、血浆β-EP、血清TNF-α和IL-6水平。结果与T0点相比,对照组在T1时点MAP和HR显著升高(P<0.05),T1～T3时点血糖、血浆β-EP浓度显著升高(P<0.05),T1～T2时点血清TNF-α和IL-6的浓度明显上升(P<0.05);盐酸右美托咪定组在各时点均无明显变化,两组各时间点差异有统计学意义(P<0.05)。结论全麻期间持续应用盐酸右美托咪定可有效降低食管癌根治术患者围术期血糖、血浆β-EP、血清TNF-α和IL-6水平,抑制围术期应激反应。
Objective To observe the effects of continuous application of dexmedetomidine hydrochloride during perioperative period on perioperative blood glucose, β-endorphin (β-EP), tumor necrosis factor α (TNF-α) and interleukin-6 IL-6) expression levels. Methods Forty patients undergoing radical resection of esophageal cancer were enrolled. All patients were randomly divided into two groups: dexmedetomidine hydrochloride group and control group (n = 20). The venous blood samples were collected before induction of anesthesia (T0), immediately after extubation (T1), on the first day of operation (T2) and 2 days (T3) after operation. Blood glucose, plasma β-EP, -6 level. Results Compared with T0, the MAP and HR of control group were significantly increased at T1 (P <0.05), and the levels of blood glucose and plasma β-EP were significantly increased at T1 ~ T3 (P <0.05) (P <0.05). The dexmedetomidine hydrochloride group had no significant changes at any time point, the difference between the two groups was statistically significant (P <0.05) . Conclusion Continuous application of dexmedetomidine hydrochloride during general anesthesia can effectively reduce perioperative blood glucose, plasma β-EP, serum TNF-α and IL-6 levels and inhibit perioperative stress response in patients with radical resection of esophageal cancer.