| 右美托咪定预处理对老年腹腔镜手术患者术后氧化应激水平及肠屏障功能的影响 |
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| 引用本文： | 刘浩,鲁金钢,赵鹏程,徐凯.右美托咪定预处理对老年腹腔镜手术患者术后氧化应激水平及肠屏障功能的影响[J].中华全科医学,2020,18(4):585. |
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| 作者姓名： | 刘浩 鲁金钢 赵鹏程 徐凯 |
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| 作者单位： | 1. 杭州市西溪医院麻醉科, 浙江 杭州 310023; |
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| 基金项目： | 浙江省医学会临床科研项目(2018ZYC-A37) |
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| 摘 要： | 目的 分析右美托咪定预处理对老年腹腔镜患者术后氧化应激水平及肠屏障功能的影响。 方法 将2018年1—12月于杭州市西溪医院行腹腔镜治疗的74例患者,依据是否接受右美托咪定预处理将其分为右美托咪定组(37例)及对照组(37例),对2组患者一般资料及麻醉前、麻醉后1 min、麻醉后5 min及麻醉后30 min的心率、血压进行比较,并对患者术后24 h氧化应激及肠屏障功能进行比较。 结果 2组患者的血压、心率、不良反应及术前氧化应激、肠屏障功能差异无统计学意义(均P>0.05);右美托咪定组患者的镇静起效及停药后苏醒时间均明显低于对照组(均P<0.05),术后1 h及2 h的Ramsay评分明显高于对照组(均P<0.05),且右美托咪定组芬太尼用量明显少于对照组(P=0.001);术后2组患者的MDA较前升高,SOD、GSH-Px、TAS、I-FABP、内毒素、DAO及D-乳酸较前降低,右美托咪定组患者的MDA、I-FABP、内毒素、DAO及D-乳酸明显低于对照组(均P<0.05),SOD、TAS、GSH-Px明显高于对照组(均P<0.05)。 结论 右美托咪定预处理可有效缩短镇静起效及手术后苏醒时间,能有效改善患者术后肠道受损情况,减轻患者的氧化应激发生。
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| 关 键 词： | 右美托咪定 腹腔镜手术 氧化应激 肠屏障功能 |
| 收稿时间： | 2019-07-08 |
Effects of dexmedetomidine preconditioning on postoperative oxidative stress and intestinal barrier function in elderly patients undergoing laparoscopic surgery |
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| Affiliation: | Department of Anesthesiology, Xixi Hospital of Hangzhou, Hangzhou, Zhejiang 310023, China |
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| Abstract: | Objective To analyze the effects of dexmedetomidine pretreatment on postoperative oxidative stress and intestinal barrier function in elderly patients undergoing laparoscopic surgery. Methods Seventy-four patients who underwent laparoscopic surgery at Xixi Hospital from January to December 2018 were divided into dexmedetomidine group(37 cases) and control group(37 cases) according to whether they received dexmedetomidine pretreatment. The general data, heart rate and blood pressure before anesthesia, 1 min, 5 min and 30 min after anesthesia were compared. The oxidative stress and intestinal barrier function were compared 24 h after surgery. Results There were no significant differences in blood pressure, heart rate, adverse reactions, preoperative oxidative stress, and intestinal barrier function between the two groups(all P>0.05). The sedative effect and the recovery time after stopping the drug of the dexmedetomidine group were significantly lower than those of the control group(all P<0.05). The Ramsay scores at 1 h and 2 h after operation of the dexmedetomidine group were significantly higher than those of the control group(all P<0.05). The dose of fentanyl of the dexmedetomidine group was significantly lower than that of the control group(P=0.001). The MDA of the two groups was increased, and the SOD, GSH-Px, TAS, I-FABP, endotoxin, DAO and D-Lactic acid was decreased after operation. The MDA, I-FABP, endotoxin, DAO and D-lactic acid of the dexmedetomidine group were significantly lower than those of the control group(all P<0.05), and the SOD, TAS, GSH-Px were significantly higher than those of the control group(all P<0.05). Conclusion Pretreatment with dexmedetomidine can effectively shorten the onset of sedation and recovery time after surgery, which can effectively improve the postoperative intestinal damage and reduce the occurrence of oxidative stress. |
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