盐酸艾司洛尔联合右美托咪定对肺癌患者应激反应和Th1/Th2型细胞因子的影响

Effect of Esmolol Hydrochloride Combined with Dexmedetomidine on Stress Response and Th1/Th2 Cytokines in Lung Cancer Patients

目的:探讨盐酸艾司洛尔联合右美托咪定对肺癌患者应激反应和辅助性T细胞1(Th1)/Th2型细胞因子的影响。方法:选取武汉科技大学附属天佑医院2020年6月~2022年3月期间收治的肺癌根治术患者112例。按照随机数字表法将患者分为对照组(n=56,常规麻醉联合盐酸右美托咪定注射液)和研究组(n=56,对照组基础上联合盐酸艾司洛尔注射液)。对比两组苏醒质量、肺功能指标、应激反应指标、Th1/Th2型细胞因子和术后肺部并发症发生率变化情况。结果:研究组的呼吸恢复时间、定向力恢复时间、拔管时间短于对照组(P<0.05)。研究组术后肺部并发症发生率低于对照组(P<0.05)。研究组术毕动态肺顺应性(Cdyn)高于对照组,平台压(Pplat)、气道峰压(Ppeak)低于对照组(P<0.05)。研究组术毕皮质醇(Cor)、去甲肾上腺素(NE)及肾上腺素(E)低于对照组(P<0.05)。研究组术毕肿瘤坏死因子-α(TNF-α)、白细胞介素-2(IL-2)低于对照组(P<0.05),研究组术毕白细胞介素-10(IL-10)、转化生长因子-β1(TGF-β1)高于对照组(P<0.05)。结论:盐酸艾司洛尔联合右美托咪定用于肺癌根治术中,具有较好的麻醉效果,可有效减轻术中应激反应,调节免疫功能并保护肺功能,还可降低术后肺部并发症发生率。

Objective:To investigate the effects of esmolol hydrochloride combine with dexmedetomidine on stress response and helper T cell 1(Th1)/Th2 cytokines in lung cancer patients.Methods:A total of 112 patients with lung cancer undergoing radical surgery who were admitted to Tianyou Hospital affiliated with Wuhan University of Science and Technology from June 2020 to March 2022 were selected.The patients were divided into control group(n=56,conventional anesthesia combined with dexmedetomidine hydrochloride injection)and study group(n=56,control group combined with esmolol hydrochloride injection)according to the random number table method.Awakening quality,lung function indicators,stress response indicators,Th1/Th2 cytokines,and postoperative pulmonary complications between the two groups were compared.Results:The respiratory recovery time,directional recovery time,and extubation time of the study group were shorter than those of the control group(P<0.05).The incidence of postoperative pulmonary complications in the study group was lower than that in the control group(P<0.05).The postoperative dynamic lung compliance(Cdyn)of the study group after operation was higher than that of the control group,while platform pressure(Pplat)and peak airway pressure(Ppeak)were lower than those of the control group(P<0.05).The postoperative cortisol(Cor),norepinephrine(NE),and epinephrine(E)levels in the study group after operation were lower than those in the control group(P<0.05).Tumor Necrosis Factor-α(TNF-α),interleukin-2(IL-2)of the study group after operation were lower than those of the control group(P<0.05),Interleukin-10(IL-10),transforming growth factor-β1(TGF-β1)of the study group after operation were higher than those of the control group(P<0.05).Conclusion:Esmolol hydrochloride combine with dexmedetomidine has a good anesthetic effect in radical lung cancer surgery,which can effectively reduce intraoperative stress response,regulate immune function,and protect lung function.It can also reduce the incidence of postoperative pulmonary complications.