右美托咪定联合地塞米松对单肺通气手术患者的肺保护作用研究(1)
[摘要] 目的 探讨右美托咪定联合地塞米松对单肺通气手术患者的肺保护作用。方法 方便选取2016年6月—2018年3月在该院胸外科行肺叶切除术的78例患者，随机分为两组，均在全麻单肺通气下进行手术，观察组术中使用右美托咪定联合地塞米松，对照组术中仅给予生理盐水及地塞米松，比较两组患者的各项手术指标、术中炎性因子及氧化应激指标。结果 观察组单肺通气时间、机械通气时间、手术时间、输血量、输液量、住院时间与对照组相比差异无统计学意义(P>0.05)；观察组单肺通气60 min后的IL-1β(115.29±17.32)ng/L、TNF-α(9.52±0.95)ng/L、MDA(1.84±0.42)nmol/mg Prot、XOD(10.16±0.84)U/gprot、MPO(0.48±0.24)anson/g(AU)均明显低于对照组(t=20.012、6.364、3.316、4.124、3.926，P<0.05)，而IL-10(11.45±0.76)ng/L明显升高(t=5.026，P<0.05)。结论 右美托咪定联合地塞米松对单肺通气手术患者的肺保护作用确切，能有效降低炎性反应和氧化还原反应，避免急性肺损伤的发生，具有积极的临床意义。
[关键词] 单肺通气手术；右美托咪定；地塞米松；肺保护作用
[中图分类号] R614 [文献标识码] A [文章编号] 1674-0742(2018)10(b)-0134-03
[Abstract] Objective To investigate the protective effect of dexmedetomidine combined with dexamethasone on lung injury in patients with single lung ventilation. Methods 78 patients who underwent lobectomy in the department from June 2016 to March 2018 were conveniently selected and randomly divided into two groups. All patients underwent surgery under general anesthesia with single lung ventilation. The observation group used dexmedetomidine in combination with dexamethasone， the control group received only normal saline and dexamethasone. The surgical indexes， intraoperative inflammatory factors and oxidative stress were compared between the two groups. Results There was no significant difference in single lung ventilation time， mechanical ventilation time， operation time， blood transfusion volume， infusion volume and hospitalization time between the observation group and the control group(P>0.05). The IL-1β of the observation group was 60 min after single lung ventilation. (115.29±17.32)ng/L， TNF-α (9.52±0.95)ng/L， MDA (1.84±0.42)nmol/mg Prot， XOD (10.16±0.84)U/gprot， MPO (0.48±0.24)anson/g(AU) were significantly lower In the control group (t=20.012， 6.364， 3.316， 4.124， 3.926， P<0.05)， IL-10 (11.45±0.76) ng/L was significantly elevated(t=5.026， P<0.05). Conclusion The combination of dexmedetomidine and dexamethasone in the lung protection of patients with single-lung ventilation can effectively reduce the inflammatory response and redox reaction and avoid the occurrence of acute lung injury. It has positive clinical significance.
[Key words] Single lung ventilation； Dexmedetomidine； Dexamethasone； Lung protection
單肺通气(OLV)是一般开胸手术使用的通气方法，通过患侧肺萎缩，有利于手术操作及病变范围的明确，使手术进行更为顺利。但临床发现OLV可引发一系列病理生理改变，出现低氧血症、缺血再灌注损伤等，触发全身性炎症反应及氧化应激反应[1]。因此，加强OLV手术期间的肺保护有重要的临床意义。该研究选取2016年6月—2018年3月在该院收治的78例患者为研究对象，分析右美托咪定联合地塞米松对单肺通气手术患者的肺保护作用，现报道如下。, 百拇医药(高清贤 袁振飞 尹治青)
[关键词] 单肺通气手术；右美托咪定；地塞米松；肺保护作用
[中图分类号] R614 [文献标识码] A [文章编号] 1674-0742(2018)10(b)-0134-03
[Abstract] Objective To investigate the protective effect of dexmedetomidine combined with dexamethasone on lung injury in patients with single lung ventilation. Methods 78 patients who underwent lobectomy in the department from June 2016 to March 2018 were conveniently selected and randomly divided into two groups. All patients underwent surgery under general anesthesia with single lung ventilation. The observation group used dexmedetomidine in combination with dexamethasone， the control group received only normal saline and dexamethasone. The surgical indexes， intraoperative inflammatory factors and oxidative stress were compared between the two groups. Results There was no significant difference in single lung ventilation time， mechanical ventilation time， operation time， blood transfusion volume， infusion volume and hospitalization time between the observation group and the control group(P>0.05). The IL-1β of the observation group was 60 min after single lung ventilation. (115.29±17.32)ng/L， TNF-α (9.52±0.95)ng/L， MDA (1.84±0.42)nmol/mg Prot， XOD (10.16±0.84)U/gprot， MPO (0.48±0.24)anson/g(AU) were significantly lower In the control group (t=20.012， 6.364， 3.316， 4.124， 3.926， P<0.05)， IL-10 (11.45±0.76) ng/L was significantly elevated(t=5.026， P<0.05). Conclusion The combination of dexmedetomidine and dexamethasone in the lung protection of patients with single-lung ventilation can effectively reduce the inflammatory response and redox reaction and avoid the occurrence of acute lung injury. It has positive clinical significance.
[Key words] Single lung ventilation； Dexmedetomidine； Dexamethasone； Lung protection
單肺通气(OLV)是一般开胸手术使用的通气方法，通过患侧肺萎缩，有利于手术操作及病变范围的明确，使手术进行更为顺利。但临床发现OLV可引发一系列病理生理改变，出现低氧血症、缺血再灌注损伤等，触发全身性炎症反应及氧化应激反应[1]。因此，加强OLV手术期间的肺保护有重要的临床意义。该研究选取2016年6月—2018年3月在该院收治的78例患者为研究对象，分析右美托咪定联合地塞米松对单肺通气手术患者的肺保护作用，现报道如下。, 百拇医药(高清贤 袁振飞 尹治青)