右美托咪定对老年食管癌根治术患者氧化应激及血流动力学的影响

Effect of dexmedetomidine hydrochloride on oxidative stress and hemodynamics in elderly patients undergoing radical resection of esophageal cancer

目的探讨右美托咪定对老年食管癌根治术患者氧化应激及血流动力学的影响。方法将90例于该院就诊的老年食管癌患者随机分为观察组和对照组各45例。对照组行常规全麻,并静脉泵入生理盐水,观察组行常规全麻,并静脉泵入右美托咪定。比较两组术前、术后1、7 d氧化应激指标超氧化物歧化酶(SOD)活性及丙二醛(MDA)水平变化,以及诱导前、诱导后10 min、插管时、插管后30 min、拔管后30 min血流动力学指标心率(HR)、平均动脉压(MAP)变化。结果术后1 d,两组患者SOD水平较术前明显降低,MDA水平明显升高,但观察组SOD、MDA水平变化幅度明显更小(均P<0.05),术后7 d,两组患者SOD、MDA水平基本恢复,与术前无明显差异(P>0.05);两组诱导后10 min、插管后30 min、拔管后30 min HR水平较诱导前均显著下降(P<0.05),插管时HR水平较诱导前明显升高(P<0.05),其中对照组诱导后10 min、插管后30 min、拔管后30 min HR水平降低、插管时HR水平均较观察组增高明显(P<0.05);观察组诱导后10 min、插管时、插管后30 min、拔管后30 min MAP值均较诱导前显著下降(P<0.05),但4个时间点MAP值基本处于平稳状态,对照组诱导后10 min、插管后30 min、拔管后30 min MAP值均较诱导前显著下降(P<0.05),且明显低于观察组同期,插管时MAP值较诱导前明显增高(P<0.05),且明显高于观察组同期(P<0.05)。结论右美托咪定可降低老年食管癌根治术患者氧化应激损伤,并且有助于维持麻醉诱导期血流动力学的稳定。

Objective To investigate the effect of dexmedetomidine hydrochloride on oxidative stress and hemodynamics in elderly patients undergoing radical resection of esophageal cancer.Methods 90 elderly patients were divided into observation（ 45 cases） and control groups（ 45 cases） who received radical resection of esophageal cancer. The two groups were given the conventional therapy,in addition,the patients of control group were intravenously pumped with normal saline,the patients of observation group were intravenously pumped with dexmedetomidine hydrochloride. The levels of SOD and MDA were tested and compared before operation,1 day and 7 days after operation,the levels of HR and MAP were tested and compared before induction,10 min after induction,intubation,30 min after intubation and 30 min after extubation.Results Compared with before operation,the level of SOD was decreased and the level of MDA was increased significantly 1 day after operation in 2 groups（ P〈0.05）,but those of observation group were variation width significantly smaller（ P〈0.05）. Compared with before induction,the level of HR was decreased significantly at 10 min after induction,30 min after intubation and 30 min after extubation（ P〈0.05） while the level of HR was increased significantly at intubation in 2 groups（ P〈0.05）,but the level of HR of observation group was variation width significantly smaller（ P〈0.05）. Compared with before induction,the level of MAP was decreased significantly at 10 min after induction,30 min after intubation and 30 min after extubation in two groups（ P〈0. 05）,and these indexes were higher in control group than those of observation group（ P〈0.05）.Conclusions Dexmedetomidine hydrochloride could reduce oxidative stress,and contribute to maintain stable hemodynamics in elderly patients undergoing radical resection of esophageal cancer.