Effects of dexmedetomidine on the protection of lung in lung cancer patients with single lung ventilation
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摘要: 目的 分析右美托咪定对肺癌单肺通气患者肺的保护作用。 方法 纳入82例拟在单肺通气麻醉状态下行外科手术治疗的肺癌患者,根据数字表法随机分为对照组40例和观察组42例。在麻醉诱导前,观察组患者静脉注射盐酸右美托咪定注射液,以0.5 μg/kg的负荷计量,在10 min内输注完毕,接着以0.25 μg/(kg·h)的速度静脉滴注至手术前30 min;对照组患者静脉滴注相同容量生理盐水溶液。对比2组患者麻醉诱导前(T0)、单肺通气前即刻(T1)、单肺通气30 min (T2)、单肺通气60 min (T3)、膨肺后30 min (T4)、术后24 h (T5)6个时间点的中性粒细胞(PMN)数量、血清黄嘌呤氧化酶(XOD)以及髓过氧化物酶(MPO)水平。对比2组患者手术情况以及各种麻醉药物治疗用量。 结果 2组T2、T3、T4、T5时间点PMN、XOD及MPO值均明显高于T0时间点(P<0.05);观察组T2、T3、T4、T5时间点PMN、XOD及MPO值均明显低于对照组(P<0.05)。2组术中出血量、24 h尿量、补液量差异无统计学意义(P>0.05);观察组患者苏醒时间和对照组比较明显较长,差异有统计学意义(P<0.05)。观察组患者瑞芬太尼和异丙酚用量明显低于对照组,差异有统计学意义(P<0.05);顺式阿曲库铵用量的差异无统计学意义(P>0.05)。 结论 右美托咪定可降低肺癌单肺通气患者PMN计数以及血清XOD、MPO表达水平,对肺组织具有积极保护作用。Abstract: Objective To analyze the effect of dexmedetomidine on the protection of lung in lung cancer patients with single lung ventilation. Methods Eighty-two lung cancer patients who received surgical treatment under single lung ventilation anesthesia,and the patients were randomly divided into the control group(n=40) and the observation group(n=42).Before anesthesia induction,the patients in the observation group received intravenous injection of dexmedetomidine hydrochloride with the loading dose of 0.5 μg/kg,and finished infusion within 10 minutes,then received intravenous infusion at 0.25 μg/(kg·h) till 30 minutes before surgery;and the patients in the control group received intravenous infusion of physiological saline solution with the same volume.The number of neutrophils(PMN),serum xanthine oxidase(XOD) and myeloperoxidase(MPO) levels before anesthesia induction(T0),at the moment of single lung ventilation(T1),30 minutes after single lung ventilation(T2),60 minutes after single lung ventilation(T3),30 minutes after lung expansion(T4) and 24 hours after surgery were compared between two groups.The surgical condition and the amount of various narcotic drugs were compared between two groups. Results The PMN,XOD and MPO levels in two groups at T2,T3,T4 and T5 time points were significantly higher than those at T0 time point(P<0.05).The PMN,XOD and MPO levels at T2,T3,T4 and T5 time points in the observation group were significantly lower than those in the control group(P<0.05).There were no significant differences in intraoperative blood loss,24-hour urine output and fluid volume between two groups(P>0.05).The recovery time of the observation group was significantly longer than that of the control group,and the difference was statistically significant(P<0.05).The remifentanil and propofol dosage in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in cisatracurium dosage(P>0.05). Conclusion Dexmedetomidine can reduce the PMN count and serum XOD,MPO expression level in lung cancer patients with single lung ventilation,which have a positive protective effect on lung tissues.
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Key words:
- Lung Cancer /
- Ischemia-Reperfusion /
- Dexmedetomidine /
- Xanthine Oxidase /
- Neutrophils
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