【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。更多还原

【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.更多还原