右美托咪定对肺部手术患者抗氧化能力、NO水平及心肺功能的影响

[目的]探讨右美托咪定对肺部手术患者抗氧化能力、一氧化氮(NO)水平及心肺功能的影响.[方法]择期全麻肺部手术患者76例随机分为对照组(C组)和右美托咪定组(D组),各38例.开胸前(T0)、单肺通气(OLV)后60 min(T1)、术毕即刻(T2)检测肿瘤坏死因子(TNF-α)、白介素6(IL-6)、NO、丙二醛(MAD)、超氧化物歧化酶(SOD),并于T0~T2时测定心搏指数(SI)、心脏指数(CI)、气道平台压、气道阻力和肺顺应性;记录两组围手术期不良反应.[结果]与T0时相比,两组T1、T2时TNF-α、IL-10、TNF-α、IL-10、NO、MDA均升高,SOD降低(P<0.05);与C组T1、T2时相比,D组TNF-α、IL-10、NO、MDA较低,SOD较高(P<0.05).与T0时相比,D组T1、T2时SI、CI、气道平台压、气道阻力、肺顺应性无明显变化(P>0.05),C组T1时上述指标无变化(P>0.05),T2时SI、CI均降低,气道平台压、气道阻力、肺顺应性均升高(P<0.05);与C组T2时比较,D组SI、CI较高,气道平台压、气道阻力、肺顺应性较低(P<0.05).D组围手术期不良反应发生率为7.89%明显低于C组的26.32%(P<0.05).[结论]肺部手术患者围手术期给予右美托咪定,可降低炎性水平,减轻氧化应激损伤,有利于心肺功能恢复.

Effects of Dexmedetomidine on Oxidation Resistance,NO Level and Cardiopulmonary Function in Patients Undergoing Lung Surgery

[Objective]To explore the effects of dexmedetomidine on oxidation resistance, nitric oxide ( NO) level and cardiopulmonary function in patients undergoing lung surgery.[Methods]A total of 76 patients who received pulmona-ry surgery under general anesthesia were divided into a control group ( group C) and a dexmedetomidine group ( group D) , with 38 cases each. Tumor necrosis factor ( TNF-α) , interleukin-6 ( IL-6) , NO level, malonaldehyde ( MAD) , and superoxide dismutase ( SOD) were detected before opening the chest ( T0 ) , 60min after OLV ( T1 ) and at the end of op-eration ( T2 ) . Stroke index ( SI) , cardiac index ( CI) , airway plateau pressure, air way resistance and lung compliance at T0 to T2 were determined as well. Adverse drug reactions in two groups during the perioperative period were recorded.[Results]Compared to those at T0, TNF-α, IL-10, TNF-α, IL-6, IL-10, NO, MDA in the two groups at T1 and T2 were significantly increased, while SOD level was significantly decreased ( P <0.05). Compared to group C at T1 and T2, TNF-α, IL-10, NO, MDA in the group D were significantly lower;however, SOD was significantly higher ( P<0.05). In group D, there were no significant changes in SI, CI, airway plateau pressure, air way resistance and lung compliance at T1 and T2 compared to T0( P>0.05) . The above indexes in group C at T1 were not changed ( P>0.05) , but SI, CI at T2 were significantly decreased. Airway plateau pressure, airway resistance and lung compliance were significantly in-creased ( P<0.05) . Compared to group C at T2 , SI and CI in group D were significantly higher and airway plateau pres-sure, air way resistance and lung compliance were significantly lower ( P<0.05). The adverse reaction rate during the perioperative period of group D was 7.89%, was significantly lower than that of group C, which was 26.32% ( P<0.05) .[Conclusion] The application of dexmedetomidine in lung surgery during the perioperative period can reduce inflammatory levels and alleviate oxidative stress injury. It is beneficial to the recovery of cardiopulmonary function.