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目的:研究丙泊酚联合右美托咪啶用于肺癌根治术患者中的镇痛效果及对应激反应的影响。方法:选取2014年8月至2016年7月本院收治的肺癌根治术患者78例,根据患者入院顺序分为观察组和对照组,39例每组。对照组采取咪达唑仑联合右美托咪啶进行麻醉,观察组采取丙泊酚联合右美托咪啶进行麻醉,两组均复合使用瑞芬太尼维持。比较两组患者镇痛效果、平均动脉压、心率、血糖、血清白介素-6(IL-6)、白介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)及白细胞总数(WBC)水平。结果:观察组患者在苏醒即刻、苏醒后10 min、苏醒后30 min的视觉模拟(VAS)评分显著低于对照组(P<0.05),治疗后24小时血清IL-6、TNF-α、WBC、心率、平均动脉压、血糖水平均显著低于对照组(P<0.05),血清白介素(IL-10)水平显著高于对照组(P<0.05)。观察组和对照组的不良反应发生率比较差异无统计学意义(P>0.05)。结论:丙泊酚联合右美托咪啶用于肺癌根治术患者中具有较好的镇痛效果,并能有效抑制应激反应,安全性高。
Objective: To study the analgesic effect of propofol combined with dexmedetomidine in patients undergoing radical resection of lung cancer and its effect on stress response. Methods: From August 2014 to July 2016, 78 patients undergoing radical resection of lung cancer undergoing radical resection in our hospital were divided into observation group and control group according to the order of admission and 39 patients in each group. The control group was given midazolam combined with dexmedetomidine for anesthesia. The observation group was given propofol combined with dexmedetomidine for anesthesia. Both groups were given remifentanil in combination. The analgesic effect, mean arterial pressure, heart rate, blood glucose, serum levels of interleukin-6, interleukin-10, tumor necrosis factor-alpha and total white blood cells (WBC) were compared between the two groups )Level. Results: The visual analogue (VAS) scores of patients in observation group immediately after awakening, 10 min after awake and 30 min after awake were significantly lower than those in control group (P <0.05). After 24 h, the levels of serum IL-6, TNF- Heart rate, mean arterial pressure and blood glucose level were significantly lower than those in the control group (P <0.05). Serum interleukin (IL-10) levels were significantly higher than those in the control group (P <0.05). There was no significant difference in the incidence of adverse reactions between the observation group and the control group (P> 0.05). Conclusion: Propofol combined with dexmedetomidine has a good analgesic effect in patients with radical resection of lung cancer and can effectively suppress the stress response with high safety.