右美托咪定与羟考酮联用对妇科腹腔镜手术苏醒期全身应激反应程度的影响

Effect of dexmedetomidine combined with oxycodone on systemic stress response in recovery of gynecological laparoscopic operation

目的:研究右美托咪定与羟考酮联用对妇科腹腔镜手术苏醒期全身应激反应程度的影响。方法:选择2014年6月~2016年12月在昆明医科大学第二附属医院接受腹腔镜手术的86例患者,随机分为右美托咪定联合羟考酮组(DO组)和对照组(C组)。麻醉诱导前(T1),手术结束时、微泵注入右美托咪定及盐酸羟考酮前(T2),苏醒期(T3)时,测定血清中垂体-靶腺轴相关激素、血管活性相关激素、氧化应激相关分子的含量。结果:T1、T2时,DO组患者血清中促甲状腺激素(TSH)、T3、T4、促肾上腺皮质激素(ACTH)、皮质醇(Cor)、NE、E、抗利尿激素(ADH)、血管紧张素(AT-II)、活性氧(ROS)、丙二醛(MDA)、超氧化物歧化酶(SOD)、HO-1的含量与C组比较无显著性差异(P>0.05);T3时,DO组患者血清中TSH、T3、T4、ACTH、Cor、NE、E、ADH、AT-Ⅱ、ROS、MDA的含量均显著低于C组,SOD、HO-1的含量均显著高于C组(P<0.05)。结论:右美托咪定与羟考酮联用对妇科腹腔镜手术苏醒期的全身应激反应具有抑制作用。

Objective：To study the effect of dexmedetomidine combined with oxycodone on systemic stress response in recovery period of gynecological laparoscopic operation.Methods：A total of 86 patients who received laparoscopic operation in the Second Affiliated Hospital of Kunming Medical University between June 2014 and December 2016 were selected and randomly divided into the dexmedetomidine combined with oxycodone group（DO group）and control group（group C）.Before anesthesia induction（T1）,at the end of the surgery and before micro pump injection of dexmedetomidine and oxycodone hydrochloride（T2）and in recovery period（T3）,serum levels of pituitary-target gland axis-related hormones,vascular activity-related hormones and oxidative stress-related molecules were determined.Results：At T1 and T2,serum TSH,T3,T4,ACTH,Cor,NE,E,ADH,AT-II,ROS,MDA,SOD and HO-1levels of DO group were not significantly different from those of group C（P〉0.05）;at T3,serum TSH,T3,T4,ACTH,Cor,NE,E,ADH,AT-II,ROS and MDA levels of DO group were significantly lower than those of group C while SOD and HO-1levels were significantly higher than those of group C（P〈0.05）.Conclusion：Dexmedetomidine combined with oxycodone can inhibit the systemic stress response in recovery of gynecological laparoscopic operation.