丙泊酚联合右美托咪啶对肺癌根治术患者镇痛及应激反应的影响

Analgesic Effects of Propofol Combined with Dexmedetomidine on the Patients Undergoing Radical Resection of Lung Cancer and Its Effect on the Stress Response

目的:研究丙泊酚联合右美托咪啶用于肺癌根治术患者中的镇痛效果及对应激反应的影响。方法:选取2014年8月至2016年7月本院收治的肺癌根治术患者78例,根据患者入院顺序分为观察组和对照组,39例每组。对照组采取咪达唑仑联合右美托咪啶进行麻醉,观察组采取丙泊酚联合右美托咪啶进行麻醉,两组均复合使用瑞芬太尼维持。比较两组患者镇痛效果、平均动脉压、心率、血糖、血清白介素-6(IL-6)、白介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)及白细胞总数(WBC)水平。结果:观察组患者在苏醒即刻、苏醒后10 min、苏醒后30 min的视觉模拟(VAS)评分显著低于对照组(P<0.05),治疗后24小时血清IL-6、TNF-α、WBC、心率、平均动脉压、血糖水平均显著低于对照组(P<0.05),血清白介素(IL-10)水平显著高于对照组(P<0.05)。观察组和对照组的不良反应发生率比较差异无统计学意义(P>0.05)。结论:丙泊酚联合右美托咪啶用于肺癌根治术患者中具有较好的镇痛效果,并能有效抑制应激反应,安全性高。

Objective：To investigate the effects of propofol combined with dexmedetomidine on the analgesia in patients undergoing radical resection of lung cancer and its effect on stress response.Methods：78 patients with radical resection of lung cancer from August 2014 to July 2016 were divided into the observation group and the control group according to the order of admission.The control group was given midazolam and dexmedetomidine for anesthesia.The observation group was treated with propofol combined with dexmedetomidine.The analgesic effect,mean arterial pressure,heart rate,blood glucose,interleukin-6（IL-6）,interleukin-10 （IL-10）,tumor necrosis factor-α （TNF-α） and total white blood cell count （WBC） levels in the two groups were compared.Results：The visual analogue （VAS） scores of patients in the observation group were significantly lower than those of the control group on waking up,at 10min and 30min after waking up （P〈0.05）,the levels of serum IL-6,TNF-α,WBC,heart rate,mean arterial blood pressure and blood glucose were significantly lower than those of the control group at 24 hours after treatment（P〈0.05）,and serum interleukin（IL-10） level was significantly higher than that of the control group 〈0.05）.There was no significant difference in the incidence of adverse reactions between the observation group and the control group （P〉0.05）.Conclusion：Propofol combined with dexmedetomidine had good anal-gesic effect in the radical resection of lung cancer,and could effectively relieve the stress reaction with high safety.