| 袁 琳,梁 培,夏洪韬,邹小蓉,冯 敏.不同剂量右美托咪定复合舒芬太尼对肺癌根治术后患者炎性细胞因子和认知功能的影响[J].,2019,19(7):1357-1361 |
| 不同剂量右美托咪定复合舒芬太尼对肺癌根治术后患者炎性细胞因子和认知功能的影响 |
| Effects of Different Doses of Dexmedetomidine Combined with Sufentanil on Inflammatory Cytokines and Cognitive Function in Patients after Radical Resection of Lung Cancer |
| 投稿时间：2018-10-12 修订日期：2018-10-31 |
| DOI：10.13241/j.cnki.pmb.2019.02.036 |
| 中文关键词: 不同剂量 右美托咪定 舒芬太尼 肺癌根治术 炎性细胞因子 认知功能 |
| 英文关键词: Different doses Dexmedetomidine Sufentanil Radical resection of lung cancer Inflammatory cytokine Cognitive function |
| 基金项目:四川省卫生厅科研基金项目（A150239） |
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| 中文摘要: |
| 摘要 目的：研究不同剂量右美托咪定复合舒芬太尼对肺癌根治术后患者炎性细胞因子和认知功能的影响。方法：选择从2017年1月到2018年6月在四川省遂宁市中心医院接受肺癌根治术治疗的患者135例进行研究。根据随机数字法将患者分成A、B、C三组各45例，各组均实施常规麻醉，而后A组、B组、C组分别给予0.04 μg/kg?h的舒芬太尼及不同低剂量（A组：低剂量0.06 μg/kg?h，B组：中剂量0.08 μg/kg?h，C组：高剂量0.1 μg/kg?h）的右美托咪定。对比各组患者入组前（T0）、术后1 d（T1）、术后2 d（T2）的呼吸循环指标、炎性细胞因子水平、简易智力状态检查（MMSE）评分及麻醉恢复室（PACU）评分。结果：各组的收缩压（SBP）、舒张压（DBP）、心率（HR）及呼吸频率（RR）呈现出不同程度的波动变化；B、C两组<1/sub>T和T2时的SBP、DBP及HR均明显低于A组，且C组又低于B组（P＜0.05）。各组T1和T2时的C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）及白细胞介素-10（IL-10）水平均明显高于T0，且T2又高于T1（P＜0.05）；B、C两组T1和T2时的CRP及TNF-α水平均明显低于A组，且C组又低于B组，而IL-10水平明显高于A组，且C组又高于B组（P＜0.05）。各组间在T0、T1和T2时的MMSE评分以及PACU评分相比，差异均无统计学意义（P＞0.05）。结论：中剂量的右美托咪定复合舒芬太尼用于对肺癌根治术患者的手术镇痛效果较好，且对患者的炎性细胞因子水平及认知功能的影响较小，用药方式较为安全，可在临床进行推广和应用。 |
| 英文摘要: |
| ABSTRACT Objective: To study the effects of different doses of dexmedetomidine combined with sufentanil on inflammatory cytokines and cognitive function in patients after radical resection of lung cancer. Methods: 135 patients who were undergone radical resection of lung cancer in Suining Central Hospital of Sichuan Province from January 2017 to June 2018 were selected to carry out research. According to the random number method, the patients were divided into three groups: A group, B group and C group, 45 cases in each group. Each group was given routine anesthesia, and then A group, B group, C group were given 0.04 μg/kg?h sufentanil and different dose (A grou: low dose with 0.06 μg/kg?h, B group:medium dose with 0.08 μg/kg?h, C group: large dose with 0.1 μg/kg?h) dexmetidine. The respiratory cycle indexes, inflammatory cytokine levels, mini-mental state examination (MMSE) score and post-anesthesia care unit (PACU) score were compared in each group before entering the group (T0), postoperative 1 d (T1), postoperative 2 d (T2). Results: The systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and respiratory rate (RR) of each group showed varying degrees of fluctuation. The SBP, DBP and HR of B and C two groups at T1 and T2 were significantly lower than those of A group, and C group was lower than that of B group(P<0.05). The levels of C reactive protein(CRP), tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) in each group at T1 and T2 were significantly higher than those at T0, and T2 was higher than T1(P<0.05). The levels of CRP and TNF-α of B and C two groups at T1 and T2 were significantly lower than those of A group, and C group was lower than B group, while the level of IL-10 was significantly higher than that of A group, and C group was higher than that of B group(P<0.05). There was no significant difference in MMSE score and PACU score between groups at T0, T1 and T2 (P>0.05). Conclusion: Medium dose dexmedetomidine combined with sufentanil has better analgesic effect on patients undergoing radical resection of lung cancer. Moreover, it has little effect on inflammatory cytokines levels and cognitive function of patients, the way of drug use is safer, which can be popularized and applied in clinic. |
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