| 摘要: |
| 目的研究右美托咪定对肺癌胸腔镜手术中单肺通气氧化应激反应及炎症性反应的影响,旨在为临床治疗提供相应的理论依据。方法选取我院在2014年7月至2016年7月期间收治的88例拟行肺癌胸腔镜手术治疗的肺癌患者。采用随机抽取的方式将患者分成两组（每组44例）,观察组患者在术前静脉输注右美托咪定,对照组输注生理盐水。记录两组患者手术时间、术中单肺通气时间、OLV时间、液体总量、术中失血量、尿量;比较两组患者在切皮前（T1）、开胸后单肺通气开始时间（T2）、单肺通气30min（T3）、单肺通气时间60min（T4）、单肺通气结束（T5）、手术结束（T6）各时段中PETCO2、气道压峰值(Pmax)的变化情况。同时观察两组患者T1与T6时点IL-8、IL-10、TNF-ɑ、肺表面活性蛋白A（SP-A）的浓度。结果两组患者在OLV时间、液体总量、手术时间、术中失血量、尿量中比较差异无统计学意义（P>0.05）;两组患者不同时点PETCO2、Pmax变化情况比较差异无统计学意义（P>0.05）;两组患者在T1时点IL-8,IL-10,TNF-ɑ,SP-A比较差异无统计学意义（P>0.05）,术后两组患者各指标水平均有升高,但是观察组患者IL-8,TNF-ɑ,SP-A的上升程度明显低于对照组,差异有统计学意义(P<0.05,而IL-10升高程度两组患者比较差异无统计学意义（P>0.05）。结论将右美托咪定运用在麻醉诱导前能抑制肺癌胸腔镜手术中单肺通气时产生的氧化应激反应以及炎症性反应,值得在临床上推广运用。 |
| 关键词: 右美托咪定 肺癌 单肺通气 氧化应激反应 炎症性反应 |
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| Effect of Dexmedetomidine on Oxidative Stress and Inflammatory Reaction in Thoracoscope Surgery by One-lung Ventilation for Patients with Lung Cancer |
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Han Xingzhong;Li Jiangang;Zhu Hongkuan
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The First People’ s Hospital of Qujing
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| Abstract: |
| Objective To explore the effect of Dexmedetomidine on oxidative stress and inflammatory reaction in thoracoscope surgery by one-lung ventilation for patients with lung cancer and provide theoretical basis for clinical treatment.Methods 88 cases admitted during July 2014 to July 2016 with lung cancer undergoing thoracoscope surgery were selected.The patients were divided into two groups（ 44 cases in each group） randomly and the patients of observation group were given Dexmedetomidine by intravenous infusion preoperatively,while the patients of control group were given saline instead. The operation time,intraoperative one-lung ventilation time,liquid volume,intraoperative blood loss,amount of urine were recorded; the change of PETCO2 and airway pressure peak( Pmax) were compared between the two groups at time before cutting leather（ T1）,start time of one-lung ventilation（ T2）,one-lung ventilation for 30 min（ T3）,one-lung ventilation time over 60 min（ T4）,the end of one-lung ventilation（ T5） and the end of surgery（ T6）.At the same time,the concentration of IL-8,IL-10,TNF-ɑ,pulmonary surfactant protein A（ SPA） were observed at T1 and T6.Results The difference at the OLV time,liquid volume,operation time,intraoperative blood loss,amount of urine between two groups had no statistical significance（ P>0. 05）; the difference of changes of PETCO2 and Pmax,at different time between two groups had no statistical significance（ P>0. 05）; The difference of concentration of IL-8,IL-10,TNF-ɑ,SP-A between two groups at T1 had no statistical significance（ P>0. 05）.The concentration of IL-8,IL-10,TNF-ɑ,SP-A were higher after operation in both groups,but the rise of IL-8,TNF-ɑ,SP-A of observation group was significantly lower than that of the control group,statistically significant（ P<0. 05）,and the difference of the rise of IL-10 between two groups had no statistical significance（ P > 0. 05）.Conclusion Dexmedetomidine can restrain the oxidative stress and inflammatory reaction in thoracoscope surgery by one-lung ventilation for patients with lung cancer and is worth clinical application. |
| Key words: Dexmedetomidine lungcancer one-lungventilation oxidativereactionstress inflammatoryreaction |
