论文部分内容阅读
目的观察右美托咪定对腹腔镜下肾上腺肿瘤切除术老年患者血清超氧化物歧化酶(SOD)、丙二醛(MDA)以及白细胞介素-6(IL-6)水平的影响。方法将56例进行腹腔镜下肾上腺肿瘤切除术的老年患者随机分为对照组28例和试验组28例。对照组予以临床常规疗法,试验组在与对照组的基础上,在麻醉诱导插管前10 min内,予以右美托咪定注射液0.5μg·kg~(-1),qd,静脉泵注,共7 d。比较2组患者的血清MDA、SOD和IL-6水平,以及比较麻醉前(T1)、气腹后5 min(T_2)、气腹后15 min(T_3)、气腹后30 min(T_4)、气腹结束后5min(T_5)各时点患者心率(HR)、平均动脉压(MAP)变化以及药物不良反应发生率。结果治疗后,试验组和对照组血清中SOD水平分别为(87.64±11.75),(66.70±9.91)U·m L~(-1),MDA水平分别为(6.31±1.52),(8.12±1.61)nmol·m L~(-1),IL-6水平分别为(1.88±0.25),(2.19±0.31)pg·m L~(-1),差异均有统计学意义(P<0.05)。在T2、T3时间点,对照组的HR分别为(85.54±12.17),(88.33±12.48)次/分,试验组的HR分别为(79.24±13.47),(80.53±11.38)次/分;对照组的MAP分别为(83.57±11.14),(86.38±11.43)mm Hg,试验组的MAP分别为(79.57±12.44),(80.18±8.33)mm Hg,2组比较差异均有统计学意义(P<0.05)。试验组和对照组的药物不良反应均为苏醒期躁动,2组的药物不良反应发生率分别为7.14%(2/28例)和10.71%(3/28例),差异有统计学意义(P<0.05)。结论右美托咪定能显著增加血清中SOD水平,降低MDA和IL-6水平,减轻腹腔镜下肾上腺肿瘤切除术患者的应激反应,围术期血流动力学平稳,药物不良反应发生率低。
Objective To observe the effects of dexmedetomidine on serum superoxide dismutase (SOD), malondialdehyde (MDA) and interleukin-6 (IL-6) levels in elderly patients undergoing laparoscopic adrenalectomy. Methods 56 cases of elderly patients undergoing laparoscopic adrenalectomy were randomly divided into control group 28 cases and test group 28 cases. The control group was given routine clinical therapy. On the basis of the control group, the experimental group was given dexmedetomidine injection 0.5μg · kg ~ (-1), qd, intravenous injection , A total of 7 d. The levels of serum MDA, SOD and IL-6 in the two groups were compared and the levels of MDA, SOD and IL-6 in the two groups were compared before anesthesia (T 1), 5 min after pneumoperitoneum (T 2), 15 min after pneumoperitoneum (T 3) Heart rate (HR), mean arterial pressure (MAP) and incidence of adverse drug reactions at each time point after pneumoperitoneum were 5 min (T_5). Results After treatment, the serum levels of SOD in the experimental group and the control group were (87.64 ± 11.75), (66.70 ± 9.91) U · m L -1, and the MDA levels were (6.31 ± 1.52) and (8.12 ± 1.61 ) nmol · m L -1 and IL-6 levels were (1.88 ± 0.25) and (2.19 ± 0.31) pg · m L -1, respectively, with statistical significance (P <0.05). The HR of the control group was (85.54 ± 12.17) and (88.33 ± 12.48) / min respectively at T2 and T3, and the HRs in the experimental group were (79.24 ± 13.47) and (80.53 ± 11.38) MAP in the two groups were (83.57 ± 11.14) and (86.38 ± 11.43) mm Hg, respectively, and MAP in the experimental group was (79.57 ± 12.44) and (80.18 ± 8.33) mm Hg, respectively <0.05). The adverse reactions of the test group and the control group were restless during the recovery period. The incidences of adverse drug reactions in the two groups were 7.14% (2/28 cases) and 10.71% (3/28 cases), respectively, with significant difference (P <0.05). Conclusion Dexmedetomidine can significantly increase the level of SOD in serum, decrease the levels of MDA and IL-6, relieve the stress response in patients undergoing laparoscopic adrenalectomy, and the hemodynamic stability during perioperative period and the incidence of adverse drug reactions low.