右美托咪定对妇科腹腔镜手术围术期患者炎性因子及应激反应的影响
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摘要
目的探讨右美托咪定(Dex)对妇科腹腔镜手术围术期患者炎性因子及应激反应的影响。方法选取行妇科腹腔镜手术患者60例,随机数字表法分为观察组和对照组各30例,患者术前常规禁食禁饮,入室后建立静脉通道。观察组于麻醉诱导前10 min静脉泵入负荷量Dex 0.5μg·kg~(-1)泵注10 min,再以Dex 0.5μg·(kg·h)~(-1)维持至术毕前10 min;对照组以生理盐水同等剂量、同等速度泵注。2组患者于麻醉前、麻醉后1 h、术后24 h抽取静脉血,离心分离血清,采用酶联免疫吸附法(ELISA)测定肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-17(IL-17),采用硫代巴比妥酸法测定丙二醛(MDA),邻苯三酚自氧化抑制比色法测定超氧化物歧化酶(SOD)。结果观察组麻醉后1 h、术后24 h血清TNF-α、IL-1β、IL-6、IL-17、MDA水平低于同期对照组(P<0.05),SOD水平高于同期对照组(P<0.05)。结论妇科腹腔镜手术患者应用Dex能够更好地抑制围术期患者应激反应,减轻炎症反应。
Objective To investigate the effect of dexmedetomidine(Dex)on inflammatory factors and stress responses during perioperative period of gynecologic laparoscopic surgery.Methods 60 patients undergoing gynecologic laparoscopy surgery were selected and randomly divided into the observation and the control group according to the random digital table method,with 30 cases in each group.Patients were given the routine fasting prohibition and intravenous access was established after entering the room.Patients in the observation group were pumped intravenously Dex 0.5 μg·kg~(-1) 10 min at 10 min before the induction of anesthesia induction,then maintained at Dex 0.5 μg·(kg·h)~(-1) until 10 min before the operation.Patients in the control group were given the same dose of normal saline at the same speed.Venous blood was collected before anesthesia,1 h after anesthesia and 24 h after anesthesia.Serum was centrifuged and separated.Tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-17(IL-17)were measured by enzyme-linked immunosorbent assay(ELISA).Malondialdehyde(MDA)was measured by thiobarbituric acid method.Superoxide dismutase(SOD)was determined by pyrogallol autoxidation inhibition color method.Results Levels of TNF-α,IL-1β,IL-6,IL-17 and MDA in serum at 1 h after anesthesia and 24 h after operation in the observation group were lower than those in the control group(P<0.05),and level of SOD was higher than that of the same control group(P<0.05).Conclusion The application of Dex in gynecologic laparoscopic surgery can better inhibit the stress reaction and reduce the inflammatory reaction during perioperative period.
Objective To investigate the effect of dexmedetomidine(Dex)on inflammatory factors and stress responses during perioperative period of gynecologic laparoscopic surgery.Methods 60 patients undergoing gynecologic laparoscopy surgery were selected and randomly divided into the observation and the control group according to the random digital table method,with 30 cases in each group.Patients were given the routine fasting prohibition and intravenous access was established after entering the room.Patients in the observation group were pumped intravenously Dex 0.5 μg·kg~(-1) 10 min at 10 min before the induction of anesthesia induction,then maintained at Dex 0.5 μg·(kg·h)~(-1) until 10 min before the operation.Patients in the control group were given the same dose of normal saline at the same speed.Venous blood was collected before anesthesia,1 h after anesthesia and 24 h after anesthesia.Serum was centrifuged and separated.Tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-17(IL-17)were measured by enzyme-linked immunosorbent assay(ELISA).Malondialdehyde(MDA)was measured by thiobarbituric acid method.Superoxide dismutase(SOD)was determined by pyrogallol autoxidation inhibition color method.Results Levels of TNF-α,IL-1β,IL-6,IL-17 and MDA in serum at 1 h after anesthesia and 24 h after operation in the observation group were lower than those in the control group(P<0.05),and level of SOD was higher than that of the same control group(P<0.05).Conclusion The application of Dex in gynecologic laparoscopic surgery can better inhibit the stress reaction and reduce the inflammatory reaction during perioperative period.
引文
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[9] 汪海松,蔡东妙,徐林梅.盐酸右美托咪定对CO2气腹下妇科腹腔镜手术患者应激反应的影响[J].中国现代医生,2016,54(21):129-131.
[10] 张阿曼,裴晓娟,张鸿,等.右美托咪定对行腹腔镜术妇科疾病患者术后VAS评分影响及安全性研究[J].陕西医学杂志,2018,47(1):87-89.
[11] 雷伟,雷怀彪,简文静,等.右美托咪定术前给药对子宫切除术患者应激与免疫功能的影响[J].当代医学,2017,23(25):102-103.
[12] 李超,牟权,梅黎明.右美托咪定对心脏瓣膜置换术患者围术期炎症反应的影响[J].医学综述,2015,21(14):2685-2687.
[13] 黄巧文,蔡丽生.右美托咪定对全麻下老年患者腹腔镜结直肠癌手术的应激水平和术后细胞因子影响[J].中国临床药理学与治疗学,2016,21(7):802-805.
[14] 韩琪,张月明.右美托咪定对妇科腹腔镜手术围术期病人TNF-α和IL-6的影响[J].青岛大学医学院学报,2015,51(6):692-694.
[15] 张静贻.右美托咪定对妇科腹腔镜手术患者围术期炎症因子及应激反应的影响[J].药物评价研究,2016,39(4):631-634.
[16] 孙宏广,龙志鑫,魏喜静,等.右美托咪定对妇科腹腔镜手术患者围术期炎症因子及应激反应影响的临床研究[J].陕西医学杂志,2018,47(4):494-496.
[17] 陶学有,田华友,李晓明,等.盐酸右美托咪定对连续硬膜外联合全麻下妇科腹腔镜手术患者全麻苏醒期的影响[J].实用临床医药杂志,2016,20(9):76-78.
[2] 张士杰,王晓明,孙悦,等.术前应用右美托咪定对妇科患者全麻诱导期心率变异性的影响[J].实用药物与临床,2016,19(7):845-848.
[3] 吕小平,王亚兰,徐慧敏,等.右美托咪定与丙泊酚用于子痫前期产妇剖宫产手术术中镇静的比较[J].中国现代应用药学,2015,32(12):1510-1513.
[4] 张继晨,孟瑞霞,杜增利.右美托咪定对老年患者下肢手术中止血带所致氧化应激及炎症反应的影响[J].华中科技大学学报(医学版),2015,44(3):310-313.
[5] 胡梦莹,王胜斌,居霞,等.不同压力二氧化碳气腹对妇科腹腔镜手术患者术后早期认知功能的影响[J].临床麻醉学杂志,2017,33(2):144-147.
[6] 史新华,汪文娟,徐玲玲,等.右美托咪定超前镇痛对妇科腹腔镜手术后患者自控镇痛的影响[J].江苏医药,2016,42(6):702-704.
[7] 兰海涛,牛金柱.右美托咪定复合硝酸甘油对妇科腹腔镜手术患者眼内压及血流动力学的影响[J].中华临床医师杂志:电子版,2015,9(5):858-861.
[8] 周晓艳,喻志远,翁海燕.右美托咪定对妇科腹腔镜手术患者术中血流动力学及炎症反应的影响[J].浙江创伤外科,2017,22(6):1215-1217.
[9] 汪海松,蔡东妙,徐林梅.盐酸右美托咪定对CO2气腹下妇科腹腔镜手术患者应激反应的影响[J].中国现代医生,2016,54(21):129-131.
[10] 张阿曼,裴晓娟,张鸿,等.右美托咪定对行腹腔镜术妇科疾病患者术后VAS评分影响及安全性研究[J].陕西医学杂志,2018,47(1):87-89.
[11] 雷伟,雷怀彪,简文静,等.右美托咪定术前给药对子宫切除术患者应激与免疫功能的影响[J].当代医学,2017,23(25):102-103.
[12] 李超,牟权,梅黎明.右美托咪定对心脏瓣膜置换术患者围术期炎症反应的影响[J].医学综述,2015,21(14):2685-2687.
[13] 黄巧文,蔡丽生.右美托咪定对全麻下老年患者腹腔镜结直肠癌手术的应激水平和术后细胞因子影响[J].中国临床药理学与治疗学,2016,21(7):802-805.
[14] 韩琪,张月明.右美托咪定对妇科腹腔镜手术围术期病人TNF-α和IL-6的影响[J].青岛大学医学院学报,2015,51(6):692-694.
[15] 张静贻.右美托咪定对妇科腹腔镜手术患者围术期炎症因子及应激反应的影响[J].药物评价研究,2016,39(4):631-634.
[16] 孙宏广,龙志鑫,魏喜静,等.右美托咪定对妇科腹腔镜手术患者围术期炎症因子及应激反应影响的临床研究[J].陕西医学杂志,2018,47(4):494-496.
[17] 陶学有,田华友,李晓明,等.盐酸右美托咪定对连续硬膜外联合全麻下妇科腹腔镜手术患者全麻苏醒期的影响[J].实用临床医药杂志,2016,20(9):76-78.