| 成 韶,杨 军,赵 凯,胡明新,邓 敏.右美托咪定对神经外科手术患者围术期血糖、血清TNF-α和IL-6水平的影响[J].,2017,17(25):4892-4895 |
| 右美托咪定对神经外科手术患者围术期血糖、血清TNF-α和IL-6水平的影响 |
| Effects of Dexmedetomidine on the Blood Glucose, TNF-α and IL-6 in Perioperative Patients with Neurosurgery |
| 投稿时间：2017-03-22 修订日期：2017-04-17 |
| DOI：10.13241/j.cnki.pmb.2017.25.022 |
| 中文关键词: 右美托咪定 神经外科 围术期 血糖 肿瘤坏死因子-α 白介素-6 |
| 英文关键词: Dexmedetomidine Neurosurgery Perioperative Blood glucose Tumor necrosis factor-α Interleukin-6 |
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| 中文摘要: |
| 摘要 目的：探讨右美托咪定（DEX）对神经外科手术患者围术期血糖、血清肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）水平的影响。方法：选取2016年2月-2016年11月我院神经外科收治的患有脑膜瘤拟择期行开颅手术的患者50例，随机分为研究组和对照组各25例。研究组患者于麻醉诱导前10 min以DEX 1.0 μg/kg加入0.9%氯化钠注射液中，配成50 mL溶液静脉输注，10 min内输完，而后以0.5 μg/kg/h输注DEX。对照组以等速输注等量0.9%氯化钠注射液。记录并对比两组麻醉诱导前10 min（T1）、诱导后（T2）、开皮时（T3）、手术1 h（T4）、手术结束时（T5）心率（HR）、平均动脉压（MAP）及血糖、血清TNF-α和IL-6水平。结果：两组患者HR在T2、T3时间点均高于T1时间点，而研究组患者HR在T2、T3时间点均低于对照组（均P<0.05）；研究组患者MAP在T3时间点高于T1时间点，对照组患者在T3、T4时间点高于T1时间点，而研究组患者MAP在T3、T4时间点均低于对照组（均P<0.05）；两组患者在T2、T3、T4、T5时间点血糖均高于T1时间点，而研究组患者在同时间点均低于对照组（P<0.05）；对照组患者在T2、T3、T4时间点血清TNF-α及IL-6均高于T1时间点（P<0.05），研究组患者不同时间点血清TNF-α及IL-6变化无统计学意义（P>0.05），且在T2、T3、T4时间点血清TNF-α及IL-6均显著低于对照组（P<0.05）。结论：DEX在神经外科手术中有维持患者血流动力学稳定、抗炎、抑制血糖升高的作用，减轻炎症反应和应激反应，从而促进神经外科手术患者术后的恢复。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the effects of dexmedetomidine on the blood glucose, tumor necrosis factor -α(TNF-α) and in- terleukin- 6(IL-6) in perioperative patients with neurosurgery. Methods: 50 patients with meningioma who were ready to accept cranioto- my in department of neurosurgery of our hospital from February 2016 to November 2016 were enrolled, they were randomly divided into research group and control group, with 25 patients in each group. The research group was given DEX 1.0 μg/kg at 10 min before anes- thesia, which was added in 0.9% sodium chloride injection 50 mL, the injection was finished in 10 min, then the DEX change to the rate of 0.5 μg/kg/h. Control group was given 0.9% sodium chloride injection with constant rate and volume. Record heart rate (HR), mean ar- terial pressure (MAP) and blood glucose, serum TNF-α, IL-6 levels of the two groups at 10min before anesthesia(T1), after the anesthesia(T2), the beginning of surgery(T3), 1 hour after the surgery beginning(T4),the end of surgery(T5). Results: Compared with T1, HR of the two groups at T2 and T3 raised significantly, but research group was lower than control group(P<0.05); In research group, compared with T1, MAP at T3 raised significantly;in control group, compared with T1, MAP at T3 and T4 raised significantly, but MAP of research group at T3 and T4 were lower than control group(P<0.05). Compared with T1, blood glucose of the two groups at T2, T3, T4 and T5 raised sig- nificantly, but the research group at same points were lower than control group(P<0.05). Serum TNF-α, IL-6 levels of control group at T2, T3 and T4 were significantly higher than T1(P<0.05), which in research group at different time points had no significant change(P>0.05), and were lower than control group at T2, T3 and T4(P<0.05). Conclusion: DEX could maintain stable hemodynamics, antiinflammation, inhibit elevated blood glucose, so as to reduce the inflammatory response and stress response in patients with neuro- surgery, then it could promote these patients postoperative recovery. |
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