右美托咪定对肺癌根治术患者围手术期脑功能、肺功能保护及应激相关指标的影响

Effect of dexmedetomidine on cerebral function and pulmonary function protection and stress reaction factors of patients with lung cancer radical resection during perioperative period

目的探讨右美托咪定对肺癌根治术患者围手术期脑功能、肺功能的保护作用及对应激相关指标的影响。方法选取2015年3月-2017年6月医院收治的拟行肺癌根治术的肺癌患者80例为研究对象,随机分为研究组与对照组各40例,分别采用右美托咪定及生理盐水静脉注射,对两组患者进行简易智能量表(MMSE)测试认知功能并记录评分,比较两组S100β蛋白、NSE水平、各时间点动脉血气指标、各时间点呼吸力学指标及应激相关指标水平。结果两组之间简易智能量表评分差异不具有统计学意义(P> 0. 05),研究组患者T3、T4、T5时间点S100β蛋白,T4、T5时间点NSE水平与对照组比较,差异具有统计学意义(P <0. 05),研究组动脉血气指标中PaO_2、RI、OI在T3、T5时间点与对照组相对差异具有统计学意义(P <0. 05),研究组Ppeak与Cdyn在T3、T5时间点与对照组相比,差异具有统计学意义(P <0. 05),术后研究组血管紧张素Ⅱ、醛固酮、皮质醇、肾上腺素水平均明显低于对照组。结论右美托咪定可有效保护患者围手术期脑功能、肺功能,减轻应激反应,值得临床推广应用。

Objective To explore the effect of dexmedetomidine on cerebral function and pulmonary function protection and stress reaction factors of patients with lung cancer radical resection during perioperative period.Methods 80 cases of lung cancer radical resection from March, 2015 to June, 2017 were randomly divided into the research group and the control group （ n =40）, respectively given dexmedetomidine and normal saline. Their cognitive function was recorded by simple intelligence scale （MMSE） test, and their S100β protein, NSE, arterial blood gas indexes, breathing mechanics indexes and stress reaction factors were compared between the two groups. Results There was no significant difference in simple intelligence scale score difference between the two groups （ P〉 0.05）. There was significant difference in S100β protein at T3, T4 and T5 points, and NSE at T4 and T5 points between the two groups （ P〈 0.05）. The arterial blood gas indexes of PaO 2, RI and OI at T3 and T5 time points showed significant differences between the two groups （ P〈 0.05）. The value of Ppeak and Cdyn at T3 and T5 time points was statistically significant between the two groups （ P〈 0.05）, Postoperatively, the levels of angiotensin Ⅱ, aldosterone, cortisol and adrenaline were significantly lower in the research group than in the control group. Conclusion Dexmedetomidine can effectively protect their cerebral function and pulmonary function and relieve stress reaction for patients , worthy of clinical popularization and application with lung cancer radical resection during perioperative period.