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右美托咪定对胃癌根治术患者应激反应、炎症因子水平的影响
Effects of dexmedetomidine on stress and inflammatory factors in patients undergoing radical gastrectomy for gastric cancer
- 第三军医大学学报 2019年41卷第2期 页码：143-147
- 作者机构：
400038 重庆，陆军军医大学(第三军医大学)第一附属医院麻醉科
- 作者简介：
[ 顾健腾，E-mail: 2448428335@qq.com GU Jianteng, E-mail: 2448428335@qq.com
- 基金信息：
DOI：10.16016/j.1000-5404.201808184
中图分类号： R730.56;R735.2;R971.2收稿：2018-08-29，
修回：2018-11-14，
纸质出版：2019-01-30
- 稿件说明：
移动端阅览
卢孙山, 杨勇, 杨智勇, 等. 右美托咪定对胃癌根治术患者应激反应、炎症因子水平的影响[J]. 第三军医大学学报, 2019,41(2):143-147.
Sunshan LU, Yong YANG, Zhiyong YANG, et al. Effects of dexmedetomidine on stress and inflammatory factors in patients undergoing radical gastrectomy for gastric cancer[J]. Journal of Third Military Medical University, 2019, 41(2): 143-147.
卢孙山, 杨勇, 杨智勇, 等. 右美托咪定对胃癌根治术患者应激反应、炎症因子水平的影响[J]. 第三军医大学学报, 2019,41(2):143-147. DOI： 10.16016/j.1000-5404.201808184.
Sunshan LU, Yong YANG, Zhiyong YANG, et al. Effects of dexmedetomidine on stress and inflammatory factors in patients undergoing radical gastrectomy for gastric cancer[J]. Journal of Third Military Medical University, 2019, 41(2): 143-147. DOI： 10.16016/j.1000-5404.201808184.
摘要
目的
2
探究右美托咪定对胃癌根治术患者应激反应、炎症因子水平的影响。
方法
2
选取2015年5月至2017年3月我院收治的胃癌根治术患者96例，依据入院时间分为对照组(
n
=48)和观察组(
n
=48)，对照组于麻醉诱导前予以生理盐水，观察组于麻醉诱导前予以右美托咪定。于注入生理盐水或右美托咪定前及术后，对患者血液样本进行采集，分析其应激指标、炎症因子及临床症状的变化。
结果
2
术后两组皮质醇(Cor)、肾上腺素(E)及促肾上腺皮质激素(ACTH)较术前均明显增加(
P
<
0.05)，且对照组Cor、E及ACTH较观察组增加更为显著(
P
<
0.05)；两组CD4
+
及CD4
+
/CD8
+
较术前明显下降(
P
<
0.05)，而超敏C反应蛋白(hs-CRP)及肿瘤坏死因子-α(TNF-α)较术前显著上升(
P
<
0.05)；且对照组CD4
+
、CD4
+
/CD8
+
下降程度与hs-CRP、TNF-α上升程度显著高于观察组(
P
<
0.05)；观察组视觉模拟疼痛评分(VAS)较对照组显著降低(
P
<
0.05)，且其不良反应发生率显著低于对照组(12.50%
vs
39.58%，
P
<
0.05)。
结论
2
右美托咪定辅助麻醉治疗可有效改善胃癌根治术患者应激反应、炎症因子水平，降低术后疼痛度与不良反应发生率。
Abstract
Objective
2
To investigate the effects of dexmedetomidine on stress and inflammatory factors in patients undergoing radical gastrectomy for gastric cancer.
Methods
2
From May
2015 to March
2017
96 patients underwent radical gastrectomy for gastric cancer in our hospital. According to the admission time
the patients were divided into control group (
n
=48) and observation group (
n
=48) and were given normal saline and dexmedetomidine before anesthesia induction
respectively. Blood samples were collected before and after the injection of normal saline and dexmedetomidine for analysis of stress indexes and immune and inflammatory factors; postoperative pain and adverse events were recorded and compared between the 2 groups.
Results
2
In both groups
blood levels of cortisol
epinephrine and adrenocorticotropic hormone (ACTH) were increased significantly after the operation (
P
<
0.05)
and such increments were more significant in the control group (
P
<
0.05). The count of CD4
+
T lymphocytes and the ratio CD4
+
/CD8
+
were significantly lowered (
P
<
0.05) while high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-α (TNF-α) were increased significantly in both groups after the operation (
P
<
0.05)
and these variations were more obvious in the control group (
P
<
0.05). Compared with those in the control group
the patients in the observation group had significantly lower Visual Analog Scale scores (
P
<
0.05) and also significantly lower incidences of postoperative adverse events (12.50%
vs
39.58%
P
<
0.05).
Conclusion
2
Dexmedetomidine-assisted anesthesia can effectively improve stress response and immune inflammatory state and reduce postoperative pain and adverse reactions in patients undergoing radical gastrectomy for gastric cancer.
关键词
Keywords
references
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