麻醉诱导前右美托咪定对全麻时肺保护作用

麻醉诱导前右美托咪定对全麻时肺保护作用

【基金】：国家自然科学基金项目批准号：

湖北中医药大学黄家湖医院

收稿日期:2017-05-17 修回日期:2017-07-19 出版日期:2017-08-25
基金资助:
国家自然科学基金（项目批准号：51303142）

The Protection for Lungs in General Anesthesia Induced by Dexmedetomidine

wujing

Huangjia lake hospital, hubei university of traditional Chinese medicine

Received:2017-05-17 Revised:2017-07-19 Online:2017-08-25

摘要/Abstract

摘要： 目的：探讨脓毒症患者全麻时，常规麻醉诱导前静脉输注右美托咪定对其肺的保护作用。方法：将拟于我院治疗的脓肿合并脓毒症休克患者68例随机分为观察组（n=34）和对照组（n=34）。两组患者均采取全身静脉麻醉后行脓肿切除术。观察组麻醉诱导前静脉输注右美托咪定，对照组输注等容量生理盐水。于两组麻醉诱导前(T0)，气管插管成功后即刻(T1)，手术开始30 min (T2)，手术结束时(T3)，拔除气管导管后(T4)抽取静脉血行肺泡-动脉氧分压差(AaDO2)、氧合指数(OI)、呼吸指数(RI)，同时监测T0~T4的平均动脉压(MAP)和心率(HR)。同时比较两组患者的手术时间、术中出血量和住院天数。结果：与T0比较，两组患者T1、T2、T3时AaDO2都升高，RI则先下降后升高，OI在T1、T2、T3时均下降(P<0.05)。两组患者T4与T0比较各指标差异无统计学意义(P>0.05)。观察组AaDO2、RI在T1、T2、T3时低于对照组，OI在T1、T2、T3时高于对照组(P<0.05)。两组患者在T0时MAP和HR差异比较无统计学意义(P＞0.05)。观察组患者T2~T4的MAP和HR均明显低于对照组 (P＜0.05)。两组患者手术时间、术中出血量和住院天数比较差异无统计学意义(P>0.05)。结论：脓毒症患者全麻时常规麻醉诱导前静脉输注右美托咪定可维持保持相对稳定的MAP和HR，对患者肺脏起到一定的保护作用。

Abstract: Objective：To study the protection for sepsis patients’ lungs in general anesthesia induced by intravenous infusion dexmedetomidine.Methods：68 cases of patients with sepsis were randomly divided into observation group (n=34) and control group (n=34). Two groups of patients were taken general intravenous anesthesia before abscess after resection. The observation group patients with general anesthesia was induced by intravenous dexmedetomidine infusion. Control group were taken physiological saline with same capacity. Two groups of patients blood was draw before anesthesia induction (T0)， the immediately time of endotracheal intubation after a successful operation (T1)， after operation started 30 min (T2)， the time of surgery end (T3)， after pulling the endotracheal tube(T4). Venous blood was taken to compare alveolar -arterial oxygen partial pressure difference (AaDO2)， oxygenation index (OI)， respiratory index (RI)， at the same time， mean arterial pressure (MAP) and heart rate (HR) in T0~T4 were monitored.The operation time， intraoperative blood loss and hospitalization days of patients in two groups was compared. Results：Compared with T0， two group patients’ AaDO2 was increased， RI was increased after decreasing， OI was decreased in T1~T3(P<0.05)， compared with T0 two groups of patients’all indexes in T4 had no statistical significance (P>0.05). Observation group AaDO2 and RI were lower than the control group in T1~T3， OI in T1~T3 was higher than the control group (P<0.05). The MAP and HR had no statistical significance in two groups of patients in T0 (P>0.05). The MAP and HR of observation group of patients in T2 to T4 were significantly lower than the control group (P<0.05). The operation time， intraoperative blood loss and hospitalization days of patients in two groups were no statistically significant difference (P>0.05).Conclusion： Sepsis patients during general anesthesia induced by intravenous infusion dexmedetomidine can keep MAP and HR relatively stable in the operation process and play an important role in the protection of patients’ lung.

【基金】：国家自然科学基金项目批准号：. 麻醉诱导前右美托咪定对全麻时肺保护作用[J]. .

wujing. The Protection for Lungs in General Anesthesia Induced by Dexmedetomidine[J]. .

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