右美托咪定预处理对肝癌切除手术患者的肝缺血再灌注损伤的价值

目的 探讨右美托咪定(Dex)预处理对于肝癌切除手术患者的肝缺血再灌注损伤的影响.方法 前瞻性选取辽宁省朝阳市第二医院拟实施半肝切除手术治疗的95例原发性肝细胞癌患者作为研究对象,采用随机数字表法分为预处理组48例和常规组47例,预处理组手术前给予Dex 0.7μg/kg,10 min内输注完毕,后以0.4μg/(kg...

Value of dexmedetomidine preconditioning on hepatic ischemia-reperfusion injury in patients undergoing hepatectomy for liver cancer

Objective To explore the effect of dexmedetomidine(Dex) pretreatment on liver ischemia-reperfusion injury in patients undergoing liver cancer resection. Methods Ninety-five patients undergoing hemihepatectomy in the Second Hospital of Chaoyang City Liaoning Province were prospectively selected as the research objects,and they were divided into the pretreatment group using a random number table method 48 cases and 47 cases in the conventional group. the pretreatment group was given Dex 0. 7 μg/kg before the operation,the infusion was completed within 10 minutes,and 0. 4 μg/(kg·h) maintained until the end of the operation,the conventional group was given the same amount of normal saline. The operation time,intraoperative blood loss,blood transfusion rate,hepatic blood flow block time,and surgical complications were compared between the two groups. The serum alanine transaminase(ALT),aspartic transaminase(AST),glutamyl transpeptidase(GGT),total bilirubin(STB),conjugated bilirubin(CB),malondialdehyde(MDA),superoxide dismutase(SOD),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),high mobility group protein B1(HMGB1),interleukin-6(IL-6) before and 24 hours after the operation were compared between the two groups of patients were compared. Results There was no statistically significant difference in the operation time,intraoperative blood loss,blood transfusion rate,and hepatic blood flow block time between the two groups of patients(P > 0. 05). Before operation,the serum ALT,AST,GGT,STB,CB test values of the pretreatment group and the routine group were compared,and there was no significant difference(P > 0. 05);24 h after the operation,the ALT,AST,GGT,STB,CB of the pretreatment group were(330. 2 ± 104. 0) U/L,(367. 1 ±110. 8) U/L,(31. 75 ± 7. 25) U/L,(65. 20 ± 11. 35) μmol/L,(37. 67 ± 6. 29) μmol/L,which were lower than the conventional group[(418. 6 ± 120. 7) U/L,(440. 8 ± 127. 6) U/L,(38. 00 ± 9. 52) U/L,(74. 18 ± 13. 37) μmol/L,(42. 52 ± 8. 06) μmol/L],the differences were statistically significant(P < 0. 05). Before surgery,there was no statistically significant difference in levels of serum MDA,SOD,TNF-α,CRP,HMGB1 and IL-6 between the pretreatment group and the routine group(P > 0. 05). 24 h after the operation,the levels of serum MDA,TNF-α,CRP,HMGB1,IL-6 were(4. 36 ± 1. 33) μmol/L,(5. 20 ± 1. 64) μg/L,(34. 75 ± 6. 83) mg/L,(258. 4 ± 41. 7)μg/L,(31. 28 ± 9. 50) μg/L,which were lower than the conventional group[(5. 11 ± 1. 57) μmol/L,(7. 00 ± 2. 17) μg/L,(43. 80 ± 8. 53)mg/L,(295. 0 ± 46. 4) μg/L,(48. 64 ± 11. 57) μg/L](P < 0. 05),the level of serum SOD [(126. 9 ± 25. 0) U/L] of the pretreatment group was higher than that of the routine group [(113. 1 ± 19. 6) U/L],the differences were statistically significant(P < 0. 05). The surgical complication rate of the pretreatment group(12. 50%) compared with the routine group(21. 28%),the difference was not statistically significant(P > 0. 05). Conclusion Dex pretreatment can significantly reduce liver ischemia-reperfusion injury and protect liver function.