右美托咪定联合帕瑞昔布钠治疗对食管癌根除术患者单肺通气时炎性因子、血气分析及应激激素水平的影响

Influence of the dexmedetomidine combined with parecoxib sodium on inflammatory factor,blood gas analysis and stress hormone levels in patients undergoing radical resection of esophageal carcinoma during one lung ventilation

目的:探讨右美托咪定联合帕瑞昔布钠治疗对食管癌根除术患者单肺通气时炎性因子、血气分析及应激激素水平的影响。方法:81例食管癌根除术患者随机分为对照组(n=41)和观察组(n=40),两组均行左侧开胸食管癌根除术,对照组给予帕瑞昔布钠处理,观察组给予帕瑞昔布钠联合右美托咪定处理,比较麻醉诱导前(T_0)、单肺通气30min(T_1)及术后120min(T_2)三个时间点炎性因子[血清肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]、血气分析[血氧分压(PaO_2)、二氧化碳分压(PaCO_2)]及应激激素[肾上腺素(E)、去甲肾上腺素(NE)]水平。结果:组内水平比较,与T_0时刻水平相比,T_1及T_2时刻两组内TNF-α、CRP、E及NE水平均显著升高(P<0.05),PaO_2水平显著降低,且T2时刻TNF-α、CRP、PaO_2及NE水平均显著高于T_1时刻,差异有统计学意义(P<0.05);组间水平比较,T0时刻TNF-α、CRP、PaO_2、E及NE水平比较,差异均无统计学意义(P>0.05),T_1及T_2时刻观察组TNF-α、CRP、E及NE水平均显著低于对照组,PaO_2水平显著高于同时刻对照组,差异有统计学意义(P<0.05);组内及任意时刻组间PaCO_2水平比较,差异均无统计学意义(P>0.05)。结论:右美托咪定联合帕瑞昔布钠可有效减轻单肺通气时炎性应激反应,改善患者血气分析指标及应激激素水平,具有重要临床价值。

Objective：To investigate the effect of dexmedetomidine combined with parecoxib sodium on the levels of inflammatory factors,blood gas analysis and stress hormone in patients undergoing radical resection of esophageal carcinoma during one lung ventilation.Methods：According to the random data table,81 cases of esophageal cancer patients were divided into the control group（n=41）and observation group（n=40）,the patients in the two groups underwent left thoracotomy esophageal cancer radical resection,the control group patients were treated with parecoxib sodium,and patients in the observation group were treated with parecoxib sodium combined with dexmedetomidine medetomidine treatment,before induction of anesthesia（T0）,30 min of one lung ventilation（T1）and 120 min after operation（T2）at three time points,the levels of inflammatory factors[tumor necrosis factor-α（TNF-α）,C reactive protein（CRP）],blood gas analysis[oxygen partial pressure（PaO2）,carbon dioxide partial pressure（PaCO2）]and stress hormone[epinephrine（E）,norepinephrine（NE）]of the two groups were compared.Results：Intra group level comparison,compared with the levels of two groups at the T0 moment,the levels of TNF-α,CRPand NE of theT1 and T2 moment were significantly increased（P〈0.05）,the level of PaO2 were significantly decreased,and T2 moment levels were significantly higher than that of T1 moment,the difference was statistical significance（P〈0.05）;There were no significant differences between the two groups of the levels of TNF-α,CRP,PaO2,E and NE of the T0 moment（P〉0.05）,the levels of TNF-α,CRP,E and NE of the observation group at the T1 and T2 moment were significantly lower than the control group,at the same time the PaO2 level was significantly higher than the control group,the difference was statistically significant（P〈0.05）;There were no statistically significant differences in PaCO2 levels between groups and at any time（P〉0.05）.Conclusion：Dexmedetomidine combined with parecoxib sodium can effectively relieve the inflammatory stress,improve the levels of the blood gas analysis index and stress hormone during one lung ventilation,has an important clinical value.