不同剂量右美托咪定对妇科腹腔镜手术患者应激反应及细胞因子水平的影响(1)
[摘要] 目的 探討不同剂量右美托咪定对妇科腹腔镜手术的效果及对应激反应以及细胞因子水平的影响。 方法 选取2014年2月～2016年2月于青岛市妇女儿童医院行妇科腹腔镜手术患者80例，根据麻醉诱导前右美托咪定注射剂量分为两组，各40例。对照组患者使用适量舒芬太尼、罗库溴铵和丙泊酚，麻醉诱导前10 min给予右美托咪定0.2 μg/kg，然后以0.5 μg/(kg·h)的速率输注至手术结束前30 min；研究组在麻醉诱导前10 min给予右美托咪定0.5 μg/kg，然后以1 μg/(kg·h)的速率输注至手术结束前30 min。观察麻醉诱导前10 min(T1)、气管插管后1 min(T2)、气腹后1 min(T3)、手术结束时(T4)HR、MAP以及TNF-α、IL-6和IL-10水平。 结果 研究组在T2～T4时MAP水平明显低于对照组，T2～T3时刻HR显著低于对照组，差异均有统计学意义(P < 0.05)。组内炎症因子水平比较显示，与同组T1时比较，T2～T4时两组TNF-α、IL-6和IL-10含量均增加，差异有统计学意义(P < 0.05)；组间比较显示，T1时两组患者TNF-α、IL-6和IL-10含量差异无统计学意义(P > 0.05)，与对照组相比，研究组T2～T4时TNF-α及IL-6含量显著减少，但IL-10含量显著增加，差异有统计学意义(P < 0.05)。 结论 妇科腹腔镜手术中使用0.5 μg/kg右美托咪定可以降低炎症因子水平，减少炎性反应，有利于手术的进行，效果较好。
[关键词] 右美托咪定；应激反应；妇科腹腔镜手术；炎症因子
[中图分类号] R614 [文献标识码] A [文章编号] 1673-7210(2017)10(a)-0078-04
[Abstract] Objective To explore the effect of different doses of Dexmedetomidine in gynecological laparoscopic operation and the influence on stress response and cytokines. Methods 80 cases of patients underwent gynecological laparoscopic operation in Women and Children's Hospital of Qingdao City from February 2014 to February 2016 were selected. According to the doses of Dexmetrine before anesthesia， patients were divided into two groups， each groups had 40 cases. Patients in the control group were treated with a moderate doses of Sufentanil， Rocuonium Bromide and Propofol. 0.2 μg/kg Dexmedetomidine was given 10 min before anesthesia induction， maintained by 0.5 μg/(kg·h) until 30 min before the end of the surgery. Patients in the study group were given 0.5 μg/kg Dexmedetomidine at 10 min before anesthesia induction， maintained by 1 μg/(kg·h) until 30 min before the end of the surgery. The HR， MAP and levels of TNF-α， IL-6 and IL-10 were detected at 10 min before anesthesia induction (T1)， 1 min after tracheal intubation (T2)， 1 min after pneumoperitoneum (T3) and the end of the operation (T4). Results At T2-T4， the MAP levels of the study group were lower than those of the control group， at T2-T3 the HR levels of the study group were lower than those of the control group， with statistically significant differences (P < 0.05). The results of inflammatory cytokine comparison within groups showed that compared with T1， at T2-T4 the levels of TNF-α， IL-6 and IL-10 significantly increased in the two groups (P < 0.05)； the results of comparison among groups showed that at T1 there were no statistically significant differences in TNF-α， IL-6 and IL-10 levels between the two groups (P > 0.05)， compared with the control group， at T2-T4 the levels of TNF-α and IL-6 significantly decreased and IL-10 levels significantly increased in the study group (P < 0.05). Conclusion The application of 0.5 μg/kg Dexmedetomidine in gynecological laparoscopic operation can reduce inflammatory cytokine levels， decrease inflammatory response， which is conducive to the operation and has great effects., 百拇医药(史建稳)
[关键词] 右美托咪定；应激反应；妇科腹腔镜手术；炎症因子
[中图分类号] R614 [文献标识码] A [文章编号] 1673-7210(2017)10(a)-0078-04
[Abstract] Objective To explore the effect of different doses of Dexmedetomidine in gynecological laparoscopic operation and the influence on stress response and cytokines. Methods 80 cases of patients underwent gynecological laparoscopic operation in Women and Children's Hospital of Qingdao City from February 2014 to February 2016 were selected. According to the doses of Dexmetrine before anesthesia， patients were divided into two groups， each groups had 40 cases. Patients in the control group were treated with a moderate doses of Sufentanil， Rocuonium Bromide and Propofol. 0.2 μg/kg Dexmedetomidine was given 10 min before anesthesia induction， maintained by 0.5 μg/(kg·h) until 30 min before the end of the surgery. Patients in the study group were given 0.5 μg/kg Dexmedetomidine at 10 min before anesthesia induction， maintained by 1 μg/(kg·h) until 30 min before the end of the surgery. The HR， MAP and levels of TNF-α， IL-6 and IL-10 were detected at 10 min before anesthesia induction (T1)， 1 min after tracheal intubation (T2)， 1 min after pneumoperitoneum (T3) and the end of the operation (T4). Results At T2-T4， the MAP levels of the study group were lower than those of the control group， at T2-T3 the HR levels of the study group were lower than those of the control group， with statistically significant differences (P < 0.05). The results of inflammatory cytokine comparison within groups showed that compared with T1， at T2-T4 the levels of TNF-α， IL-6 and IL-10 significantly increased in the two groups (P < 0.05)； the results of comparison among groups showed that at T1 there were no statistically significant differences in TNF-α， IL-6 and IL-10 levels between the two groups (P > 0.05)， compared with the control group， at T2-T4 the levels of TNF-α and IL-6 significantly decreased and IL-10 levels significantly increased in the study group (P < 0.05). Conclusion The application of 0.5 μg/kg Dexmedetomidine in gynecological laparoscopic operation can reduce inflammatory cytokine levels， decrease inflammatory response， which is conducive to the operation and has great effects., 百拇医药(史建稳)