摘要
目的探讨右美托咪定在七氟烷吸入麻醉中对肺癌手术单肺通气(OLV)患者炎症状态及肺损伤的保护作用,为临床诊断治疗提供决策依据。方法将44例行肺癌根治术患者随机分为对照组与联合组,术中采用七氟烷吸入全身麻醉单肺机械通气,联合组联用右美托咪定;观察不同时间点两组患者血清中白介素(IL)-1β、IL-10以及肿瘤坏死因子(TNF)-α水平变化;比较两组术中肺脏组织标本匀浆中丙二醛(MDA)、髓过氧化物酶(MPO)以及黄嘌呤氧化酶(XOD)水平。结果 OLV后所有患者血清IL-1β、IL-10以及TNF-α均呈显著升高趋势(P<0.05),在60min及90min,联合组血清IL-1β、TNF-α水平均显著低于对照组;在90min联合组血清IL-10水平显著高于对照组;联合组肺组织匀浆中MDA、MPO以及XOD水平均显著低于对照组(P<0.05)。结论右美托咪定在OLV治疗时具有肺脏保护作用,可使肺组织炎症及氧化应激程度显著降低。
OBJECTIVE To explore the effects of dexmedetomidine on protection of lung injury and inflammation of the lung cancer patients with one-lung ventilation under sevoflurane inhalation anesthesia so as to guide the clinical diagnosis and treatment. METHODS A total of 44 patients who received radical surgeries were divided into the control group and the combination group randomly, all the patients were given treatment of OLV, the combination group received treatment of dexmedetomidine. The serum levels of IL-1 beta, IL-10 and TNF- alpha were observed and compared; MDA, MPO and XOD levels of surgical lung tissue sample homogenate were tested and compared. RESULTS The serum levels of IL-1 beta, IL-10 and TNF- alpha increased significantly after the application of OLV with the extension of time （P〈0.05） ; 60min（T2） and 90 min（T3） after OLV, the serum levels of IL-1 beta and TNF-alpha were significantly lower in the combination group than in the control group; 90 min after OLV, the serum level of IL-10 was significantly higher in the combination group than in the control group, the levels of MDA, XOD and MPO in surgical lung tissue sample homogenate were significantly lower in the combination group than in the control group （P〈0.05）. CONCLUSION Dexmedetomidine shows protection effects of lung during treatment of OLV, mainly via restraining extent of inflammatory and redox reactions.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第10期2343-2345,共3页
Chinese Journal of Nosocomiology
关键词
右美托咪定
单肺通气
肺损伤
Dexmedetomidine
One-lung ventilation
Lung injury
