右美托咪定联合地塞米松对单肺通气手术患者对肺损伤以及炎性因子的影响

Effects of Dexmedetomidine Combined with Dexamethasone on Lung Injury and Inflammatory Factors of Patients Receiving One-lung Ventilation Surgery

目的:探讨在单肺通气手术过程中运用右美托咪定联合地塞米松全身麻醉的麻醉效果以及对肺部损伤和炎性因子的影响。方法:对2012年12月~2015年12月期间在我院进行单肺通气手术的120例患者的病历资料进行回顾性分析。将采用右美托咪定联合地塞米松全身麻醉的60例患者设为观察组。将只进行右美托咪定麻醉的60例患者设为对照组。对比各时间点相关炎性因子的变化、同时对比两组患者各项麻醉效果及手术指标,对比两组患者肺损伤指标。结果:两组患者手术期间血清TNF-α、IL-10、TL-Iβ逐渐升高;T2后观察组TL-Iβ、TNF-α显著低于对照组,T3后观察组IL-10显著高于对照组;观察组MPO、MOD、XOD均显著低于对照组;两组患者输液总量、住院天数、OLV时间、机械通气时间、手术时间无明显差异,观察组输血总量显著低于对照组。结论:相较于单独使用右美托咪定麻醉,联合使用地塞米松能有效减轻氧化应激指标,减轻炎性反应对肺的损伤。

Objective To discuss the effects of dexmedetomidine combined with dexamethasone as general anesthesia and their effects on lung injury and inflammatory factors in the one-lung ventilation surgery. Methods The datum of cases of 120 cases of Patients receiving one-lung ventilation surgery in our hos Pital since December 2012 to December 2015 were reviewed and analyzed.50 cases of Patients receiving general anesthesia of dexmedetomidine combined with dexamethasone were set as observation group, while 50 cases of Patients receiving only dexmedetomidine anesthesia were set as control group. Comparisons were made for variations of related inflammatory factors between different time points. Meanwhile, various anesthesia effects and operation indicators between patients of two groups were compared, so did the lung injury indicators of patients in two groups. Results During the surgery, the serum TNF-α, IL-10 and TL-Iβ of patients in both grou P increased, while the TLIβ and TNF-α of Post-T2 observation group were significantly lower than those of control group, and the IL-10 of the Post-T3 observation group were obviously higher than that of control group. MPO, MOD and XOD of observation group were significantly lower than those of control group. There was no obvious difference in infusion volume, hospital stays, OLV time, duration of mechanical ventilation and operative time between two groups. In the case of total volume of blood transfusion, observation group is significantly lower than control group. Conclusion The anesthesia combined with dexamethasone can effectively relieve oxidative stress index and lung injury, reduce the damage of inflammatory reaction to lung.