| 摘要: |
| 目的:探讨右美托咪定对单肺通气(OLV)患儿炎症反应和氧化应激的影响。方法:收集2019 年9 月至2020 年1 月需要
OLV 的手术患儿,随机分为对照组(C 组)和右美托咪定组( D 组) 各25 例,D 组麻醉诱导后10 min 开始输注右美托咪定0. 5
μg/ kg,随后以0. 2 μg/ kg 的速度持续泵入至手术结束。C 组用等量生理盐水代替右美托咪定。两组患儿于OLV 前(T1)、OLV
30 min(T2)和术毕(T3)进行动脉血气分析,测定两组患儿白细胞介素(IL)-6、核因子(NF)-κB、IL-10、超氧化物歧化酶(SOD)和
丙二醛(MDA)的浓度,记录两组患儿不同时间段生命体征及麻醉药物的用量。结果:与T1 相比,T2 时间段两组患儿氧分压
(PO2 )降低,肺泡动脉氧分压差(A-aDO2 )和呼吸指数(RI) 均增高;D 组的PO2 下降,A-aDO2 和RI 升高幅度均低于C 组( P<
0. 05);与T1 相比,C 组患儿单肺通气后NF-κB、IL-6、IL-10 和MDA 水平均增高,SOD 水平降低,D 组NF-κB、IL-6、MDA 水平均
低于C 组,IL-10、SOD 水平高于C 组(P<0. 05);D 组丙泊酚及瑞芬太尼的用量少于C 组(P<0. 05)。结论:右美托咪定能改善患
儿单肺通气的氧合功能,减少单肺通气引起炎症反应及氧化应激,减少术中麻醉药物的用量。 |
| 关键词: 右美托咪定 单肺通气 炎症 氧化 应激 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2023.01.010 |
|
| 基金项目:湖南省自然科学基金项目,编号2019JJ50295;湖南省卫生计生委项目,编号B20180475。 |
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| Effects of Dexmedetomidine on Inflammatory Response and Oxidative Stress in Children During One Lung Ventilation |
| Xiao Ting, Zhang Shuibing, Pei Dongjie, Yan Lulu, Qu Shuangquan |
| (Hunan Children’s Hospital, Changsha 410007,China) |
| Abstract: |
| Objective: To investigate the effects of dexmedetomidine on inflammatory response and oxidative stress in children during
one lung ventilation (OLV). Methods: Children undergoing OLV from September 2019 to January 2020 were randomly divided into the
control group (group C) and the dexmedetomidine group (group D, 25 cases for each) according to the random number table. In group
D, 0. 5 μg/ kg dexmedetomidine was injected after anesthesia induction, and then continued to infuse at a rate of 0. 2 μg/ kg until the
end of the surgery. Group C was treated with the same amount of saline instead of dexmedetomidine. Before OLV (T1), 30 min after
OLV (T2) and after surgery (T3), arterial blood gas analysis was performed and the concentrations of NF-kB, IL-6, IL-10, SOD and
MDA were measured. Vital signs and the dosage of narcotic drugs were recorded in the two groups during designed period. Results: In
two groups, PO2 was decreased and A-aDO2 and RI were increased during T2 compared with T1. PO2 was decreased in group D, and
the degree of the increased A-aDO2 and RI was lower in group D than in group C (P<0. 05). Compared with T1, NF-kB, IL-6, IL-10
and MDA were increased and SOD was decreased after OLV. NF-kB, MDA and IL-6 in group D were lower than that in group C, while
IL-10 and SOD were significantly higher than that in group C (P<0. 05). The amount of propofol and remifentanil in group D was less
than that in group C (P<0. 05). Conclusion: Dexmedetomidine could reduce the inflammatory reaction and oxidative stress caused by
single lung ventilation, at the same time, reduce the amount of intraoperative anesthesia drug. |
| Key words: dexmedetomidine one lung ventilation inflammatory oxidative stress |
