右美托咪定应用于开胸肺癌根治术对患者围术期应激反应的影响

Effect of Dexmedetomidine on Perioperative Stress Response of Lung Cancer Patients Treated with Radical Resection

目的探讨右美托咪定应用于开胸肺癌根治术对患者围术期应激反应的影响。方法选择42例行肺癌根治术治疗的患者,随机分为2组。对照组患者麻醉过程中不予应用右美托咪定,而观察组患者予诱导麻醉及麻醉维持过程中应用右美托咪定,比较2组患者手术过程不同时间点[麻醉诱导前(T0)、气管插管完成时(T1)、手术进行1 h(T2)、手术结束时(T3)以及气管插管拔管时(T4)]氧化应激及血流动力学指标的变化。结果 2组患者T1、T2、T4时点血浆肾上腺素及皮质醇水平均显著高于T0,但观察组明显低于对照组,差异均有统计学意义(P<0.05);观察组MAP在T1、T4时点显著低于对照组,HR在T1、T2、T3、T4时点均明显低于对照组,差异均有统计学意义(P<0.05)。结论开胸肺癌根治术中应用右美托咪定能够有效减轻患者在手术过程中的应激反应,维持血流动力学的稳定。

Objective To explore the effect of dexmedetomidine on perioperative stress response of lung cancer patients treated with with radical resection. Methods 42 lung cancer patients treated with radical resection were randomly assigned to 2 groups, the control group did not receive dexmedetomidine in anesthesia, and the observation group received dexmedetomidine in the process of induced anesthesia and maintenance, oxidative stress and hemodynamics changes were compared in the 2 groups at different time points [ the time set with anesthesia before induction （ TO ）, gas tube intubation （ T1 ）, surgery for 1 h （ T2 ）, at the end of operation（ T3 ） and pull out tracheal intubation tube（T4） ]. Results The plasma epinephrineand cortisol levels at T1, T2, T4 in both groups were significantly higher than that of TO and the observation group was significantly lower than that of the con- trol group, the differences were statistically significant（ P 〈 0.05 ）. The MAP level of the observation group was significantly lower than that of the control group at T1, T4, the HR in the observation group at T1, T2, T3, T4 were significantly lower than that of the control group, the differences were statistically significant （ P 〈 0.05 ）. Conclusion The dexmedetomidine can effectively alleviate stress reaction and maintain the stability of hemodynamics in radical resection of lung cancer.