右美托咪定对腹腔镜直肠癌根治术患者血清炎性因子水平及肺功能的影响

• 作 者: 蔡浩亮 王兰 陈曦 郭丰
• 机 构: 上海中医药大学附属曙光医院麻醉科,上海,200126
• 出 处: 医学临床研究
• 发表日期: 2019年10期
• 关键词: Rectal Neoplasms／SU Laparoscopy Dexmedetomidine／TH

[目的]探讨右美托咪定(Dex)对腹腔镜直肠癌根治术患者血清炎性因子水平及肺功能的影响.[方法]100例腹腔镜直肠癌根治术患者,其中采用常规麻醉的 54例患者设为对照组,46 例在常规麻醉基础上静脉持续泵入盐酸Dex的患者设为观察组.比较两组麻醉诱导前(T0 )、人工气腹建立时(T1 )、手术结束时(T2 )的呼吸频率(RR)、心率(HR)、平均动脉压(MAP)、中心静脉压(CVP),血清炎性因子水平[C反应蛋白(CRP)、白细胞介素6(IL6)、肿瘤坏死因子α(TNFα)]水平,肺功能参数[气道阻力(Raw)、最大通气量(MVV)、第一秒用力呼气容积(FEV1)、肺动态顺应性(Cdyn)].[结果]两组 T0 时各项指标比较差异均无显著性(P ＞0.05);对照组T1 、T2 的 RR、HR、MAP、CVP均显著高于观察组(P ＜0.05).对照组术后 24 h的CRP、IL6、TNFα均显著高于观察组(P ＜0.05).对照组术后 24 h的 MVV、FEV1、Cdyn均显著低于,Raw显著高于观察组(P ＜0.01).[结论]Dex可显著降低腹腔镜直肠癌根治术患者的血清炎性因子水平,稳定其心率、呼吸及血流动力学,从而提高患者的肺功能,促进临床疗效.“,”[Objective]To investigate the effect of dexmedetomidine (Dex)on serum inflammatory factor levels and pulmonary function in patients with laparoscopic radical resection of rectal cancer.[Methods]A total of 100 patients with laparoscopic radical resection of rectal cancer were enrolled in the study.The control group contained 54 patients undergoing conventional anesthesia for the surgery,and the observation group included 46 patients with continuous intravenous infusion of Dex hydrochloride on the basis of conventional anesthesia.The respiratory rate (RR),heart rate (HR),mean arterial pressure (MAP),central venous pressure (CVP),serum inflammatory factor levels (CRP,IL6,TNFα)and lung function parameters (Raw,MVV, FEV1,Cdyn)before the induction of anesthesia (T0 ),the establishment of artificial pneumoperitoneum (T1 ),the end of surgery (T2 )were measured and compared between the two groups.[Results]There were no significant differences in terms of the above indexes at T0 between the two groups (P ＞0.05).The RR,HR, MAP and CVP of T1 and T2 in the control group were significantly higher than those the observation group (P ＜0.05).The CRP,IL6 and TNFαlevels in the control group were significantly higher than those in the observation group at 24 h after operation(P ＜0.05).The MVV,FEV1 and Cdyn of the control group were significantly lower,while Raw was significantly higher than that of the observation group at 24 hours after surgery (P ＜0.01).[Conclusion]Dex can significantly reduce serum inflammatory factor levels in patients undergoing laparoscopic radical resection,stabilize heart rate,respiration and hemodynamics,thereby improving lung function and promoting clinical outcomes.