| 罗 斌,吕建瑞,李 伟,田俊斌,薛荣亮.右美托咪定联合地佐辛在臂丛神经阻滞麻醉中的应用及对血清VEGF、IL-6、IL-10的影响[J].,2018,(23):4531-4534 |
| 右美托咪定联合地佐辛在臂丛神经阻滞麻醉中的应用及对血清VEGF、IL-6、IL-10的影响 |
| Effect of Dexmedetomidine and Dezocine on Anesthesia in Brachial Plexus Block and Its Effect on Serum VEGF, IL-6 and IL-10 |
| 投稿时间：2018-04-30 修订日期：2018-05-25 |
| DOI：10.13241/j.cnki.pmb.2018.23.031 |
| 中文关键词: 右美托咪定 地佐辛 臂丛神经阻滞 内皮细胞生长因子 炎症因子 |
| 英文关键词: Dexmedetomidine Dezocine Brachial plexus nerve block Endothelial cell growth factor Inflammatory factors |
| 基金项目:国家临床重点专科建设项目［卫办医政函2011（873号）］ |
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| 中文摘要: |
| 摘要 目的：右美托咪定联合地佐辛在臂丛神经阻滞麻醉中的应用及对血清VEGF（内皮细胞生长因子）、IL-6（白介素-6）、IL-10（白介素-10）的影响。方法：选择我院2016年10月至2017年12月94例上肢骨折内固定术患者作为本次研究对象，随机分为对照组和联合组，各47例。对照组于臂丛阻滞实施前10分钟持续泵注右美托咪定，联合组在此基础上辅助静脉推注地佐辛。随之在超声引导下行肌间沟臂丛神经阻滞对比分析两组患者臂丛神经麻醉前（T0），药物注射分钟后（T1），手术切皮（T2）、手术操作5分钟（T3）、手术操作30分钟（T4）和手术结束（T5）各时间点血流动力学、Ramsay镇静评分、VEGF、IL-6和IL-10水平。结果：联合组T1~T5时间MAP（血压）、HR（心率）均低于对照组（P<0.05）；两组SpO2（血氧饱和度）在各时间点比较差异无统计学意义（P>0.05）；联合组T1~T5时间点的Ramsay镇静评分明显优于观察组（P<0.05）；两组T1~T5时间点VEGF均上升，且联合组各时间点明显高于对照组（P<0.05）；术后24小时显示，联合组IL-6、IL-10水平显著低于对照组（P<0.05）；联合组麻醉起效时间明显短于对照组（P<0.05），镇痛持续时间、感觉神经和运动神经阻滞的持续时间明显比对照组长（P<0.05）。结论：在行上肢手术过程中，联合使用右美托咪定和地佐辛行臂丛神经阻滞麻醉镇痛效果明显，同时可有效刺激VEGF分泌，降低IL-6、IL-10炎症因子水平，加速患者术后恢复。 |
| 英文摘要: |
| ABSTRACT Objective: The application of dexmedetomidine combined with dezocine in the brachial plexus block anesthesia and its effect on the expression of serum VEGF, IL-6, IL-10 influence. Methods: 90 cases of upper extremity fracture fixation in our hospital from March 2015 to August 2017 were selected as the study subjects and randomly divided into control group and combination group, 45 cases in each group. The control group in the brachial plexus block before the implementation of 10 minutes of continuous infusion of dexmedetomidine combined group based on assisted intravenous injection of dezocine. The intermusculus brachial plexus block was fol- lowed by ultrasound guidance. Comparative analysis of two groups of patients before brachial plexus anesthesia (T0), drug injection after minute (T1), [what started? For specific time points, surgical skin incision (T2), operative operation 5 minutes (T3), operation 30 minutes (T4) and end of operation (T5) at different time points, including hemodynamics, Ramsay sedation score, VEGF, IL-6 and IL-10 levels. Results: The combined group T1~T5 time MAP (blood pressure), HR (heart rate) were lower than the control group (P<0.05); two SpO2 (oxygen saturation) there is no significant difference between each time points (P>0.05); group T1~T5 time Ramsay sedation score of ob- servation group was significantly higher than that in group two(P<0.05); T1~T5 VEGF time increased, and the combination group at each time point was significantly higher than that of the control group(P<0.05); 24 hours after operation, the level of IL-10 and IL-6 in com- bined group was significantly lower than the control group(P<0.05); combined anesthesia onset time was significantly shorter than the control group(P<0.05), The duration of analgesia, the duration of sensory nerve and motor nerve block were significantly longer than those of the control group(P<0.05). Conclusion: During the operation of upper limbs, the combination of dexmedetomidine and dezocine in brachial plexus block anesthesia has obvious analgesic effect and at the same time can effectiely stimulate the secretion of VEGF and decrease the levels of IL-6 and IL-10, Accelerate the recovery of patients after surgery. |
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