右美托咪定对行下肢止血带手术糖尿病患者的效果研究
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摘要
目的:对接受下肢止血带手术的糖尿病患者给予右美托咪定治疗的整体效果进行研究。方法:纳入2017年7月-2018年6月在笔者所在医院进行下肢止血带手术的150例糖尿病患者于本研究中,随机分为对照组和观察组,观察组于术中加用右美托咪定,对照组使用同样的方法加用等量的0.9%氯化钠溶液。在上止血带前(T0)、松止血带后15 min(T1)、松止血带后1 h(T2)和松止血带后12 h(T3)分别检测两组肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、胰岛素、血糖、血清肌钙蛋白-I(cTn-I)、磷酸肌酸激酶同工酶(CK-MB)水平,计算胰岛素敏感指数(ISI)。结果:在T1、T2、T3时,观察组TNF-α、IL-6、cTn-I、CK-MB、血糖、胰岛素水平均低于对照组,ISI高于对照组(P<0.05)。结论:对接受下肢止血带手术的糖尿病患者给予右美托咪定治疗,可减轻炎症反应,降低血糖,增加胰岛素敏感性,改善胰岛素抵抗,减轻缺血再灌注损伤。
Objective:To study the overall effect of Dexmedetomidine on diabetic patients undergoing lower limb tourniquet surgery.Method:150 patients with diabetes who underwent lower limb tourniquet surgery in our hospital from July 2017 to June 2018 were enrolled in this study.They were randomly divided into the control group and the observation group.The observation group was treated with Dexmedetomidine during operation.The control group was treated with the same amount of Saline.Tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),insulin,blood sugar,serum troponin-I(cTn-I),creatine kinase isoenzyme(CKMB) levels were measured before the upper tourniquet(T0),15 minutes after loosening the tourniquet(T1),1 hour after loosening the tourniquet(T2) and 12 hours after loosening the tourniquet(T3),and insulin sensitivity index(ISI) was calculated.Result:At T1,T2 and T3,the levels of TNF-α,IL-6,cTn-I,CKMB,blood sugar and insulin levels in the observation group were lower than those of the control group,and ISI was higher than that of the control group(P<0.05).Conclusion:Dexmedetomidine can alleviate inflammation,reduce blood sugar,increase insulin sensitivity,improve insulin resistance and reduce ischemic reperfusion injury in diabetic patients undergoing lower limb tourniquet surgery.
Objective:To study the overall effect of Dexmedetomidine on diabetic patients undergoing lower limb tourniquet surgery.Method:150 patients with diabetes who underwent lower limb tourniquet surgery in our hospital from July 2017 to June 2018 were enrolled in this study.They were randomly divided into the control group and the observation group.The observation group was treated with Dexmedetomidine during operation.The control group was treated with the same amount of Saline.Tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),insulin,blood sugar,serum troponin-I(cTn-I),creatine kinase isoenzyme(CKMB) levels were measured before the upper tourniquet(T0),15 minutes after loosening the tourniquet(T1),1 hour after loosening the tourniquet(T2) and 12 hours after loosening the tourniquet(T3),and insulin sensitivity index(ISI) was calculated.Result:At T1,T2 and T3,the levels of TNF-α,IL-6,cTn-I,CKMB,blood sugar and insulin levels in the observation group were lower than those of the control group,and ISI was higher than that of the control group(P<0.05).Conclusion:Dexmedetomidine can alleviate inflammation,reduce blood sugar,increase insulin sensitivity,improve insulin resistance and reduce ischemic reperfusion injury in diabetic patients undergoing lower limb tourniquet surgery.
引文
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[9]索才让杰,王云.右美托咪定对糖尿病患者非心脏手术围术期心血管事件的影响[J].中国药业,2018,27(21):52-54.
[10]谢秋红.右美托咪定对糖尿病患者腹腔镜胆囊切除术中血糖水平的影响[J].糖尿病新世界,2018,21(20):65-66,69.
[11]王莉,刘秀叶,郭琼梅,等.右美托咪定对糖尿病患者行下肢止血带手术炎症反应、胰岛素抵抗及心肌损伤的影响[J].河北医科大学学报,2018,39(12):1438-1441,1446.
[2]陈愉,刘绍凡,杨婧,等.右美托咪定对减轻下肢手术患者止血带诱发肢体缺血-再灌注损伤的效果[J].检验医学与临床,2016,13(17):2476-2478.
[3]程金红,张郃,龙超,等.右美托咪定在骨科下肢使用止血带手术中的应用[J].湖北科技学院学报:医学版,2013,27(3):202-204.
[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]莫伟波,黎必万,梁军,等.右美托咪定对应用气压止血带行下肢手术患者血流动力学的影响[J].中华实用诊断与治疗杂志,2012,26(12):1218-1220.
[6]高军辉,闫晓强,刘蔚,等.右美托咪定对下肢手术止血带血流动力学的影响分析[J].河北医药,2015,37(18):2800-2802.
[7]吕培军,居奇吉.骨科下肢手术止血带中采用右美托咪定对减少不良反应的效果分析[J].浙江创伤外科,2016,21(5):979-980.
[8]曹云,叶克平,胡晖.右美托咪定用于术中止血带致疼痛的效果评价[J].中国药业,2013,22(12):66-67.
[9]索才让杰,王云.右美托咪定对糖尿病患者非心脏手术围术期心血管事件的影响[J].中国药业,2018,27(21):52-54.
[10]谢秋红.右美托咪定对糖尿病患者腹腔镜胆囊切除术中血糖水平的影响[J].糖尿病新世界,2018,21(20):65-66,69.
[11]王莉,刘秀叶,郭琼梅,等.右美托咪定对糖尿病患者行下肢止血带手术炎症反应、胰岛素抵抗及心肌损伤的影响[J].河北医科大学学报,2018,39(12):1438-1441,1446.