| 王 宁,曹亚楠,朱泽飞,杨贯宇,孙振涛.盐酸右美托咪定联合依托咪酯麻醉对宫腔镜手术患者血流动力学、炎症反应及氧化应激水平的影响[J].,2021,(19):3694-3699 |
| 盐酸右美托咪定联合依托咪酯麻醉对宫腔镜手术患者血流动力学、炎症反应及氧化应激水平的影响 |
| The Effect of Dextrometramidine Hydrochloride Combined with Etomidate Anesthesia on Hemodynamics, Inflammatory Response and Oxidative Stress Level in Patients Undergoing Hysteroscopy |
| 投稿时间：2021-04-10 修订日期：2021-04-30 |
| DOI：10.13241/j.cnki.pmb.2021.19.019 |
| 中文关键词: 盐酸右美托咪定 依托咪酯 宫腔镜 血流动力学 炎症反应 氧化应激 |
| 英文关键词: Dextrometramidine hydrochloride Etomidate Hysteroscopy Hemodynamics Inflammatory response Oxidative stress |
| 基金项目:河南省医学科技攻关项目（201503037） |
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| 中文摘要: |
| 摘要 目的：研究盐酸右美托咪定联合依托咪酯麻醉对宫腔镜手术患者血流动力学、炎症反应及氧化应激水平的影响。方法：选取我院于2020年4月~2020年8月期间收治的96例择期行宫腔镜手术患者，根据住院号奇偶顺序将患者分为对照组和研究组，各48例。对照组麻醉中使用瑞芬太尼、顺阿曲库铵联合依托咪酯，研究组麻醉中使用瑞芬太尼、顺阿曲库铵、盐酸右美托咪定联合依托咪酯。对比两组麻醉诱导时间、苏醒时间、离室时间、手术时间。观察两组患者血流动力学、炎症反应及氧化应激变化。观察两组镇静、镇痛情况。记录围术期不良反应的发生情况。结果：研究组麻醉诱导时间短于对照组（P<0.05）。研究组麻醉诱导后（T2）~手术结束时（T5）时间点HR、MAP均高于对照组（P<0.05）。与对照组相比，研究组术后1 d血清白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）水平更低（P<0.05）。与对照组相比，研究组术后1 d过氧化氢（H2O2）、丙二醛（MDA）水平更低，总抗氧化态（TAS）水平更高（P<0.05）。研究组术后6 h、术后12 h视觉模拟评分法（VAS）评分低于对照组（P<0.05）。研究组术后6 h、术后12 h的Ramsay镇静评分高于对照组（P<0.05）。两组不良反应总发生率对比差异无统计学意义（P>0.05）。结论：盐酸右美托咪定联合依托咪酯麻醉用于宫腔镜手术中，镇静、镇痛效果确切，在维持血流动力学稳定、减轻炎症反应及氧化应激方面效果显著。 |
| 英文摘要: |
| ABSTRACT Objective: To study the effects of dextrometramidine hydrochloride combined with etomidate on hemodynamics, inflammatory response and oxidative stress in patients undergoing hysteroscopy. Methods: 96 patients who were treated in our hospital from April 2020 to August 2020 were selected for hysteroscopy. According to the order of hospital number parity, the patients were divided into control group and study group, 48 patients each. Remifentanil, CIS atracurium and etomidate were used in the control group, and remifentanil, CIS atracurium and dextrometramidine hydrochloride were used in the study group. The induction time, recovery time, time of departure and operation time were compared. The changes of hemodynamics, inflammatory response and oxidative stress were observed in the two groups. The sedative and analgesic conditions of the two groups were observed. The adverse reactions were recorded during the perioperative period. Results: The induction time of anesthesia in the study group was shorter than that of the control group (P<0.05). HR and MAP in the study group were higher than those in the control group from after anesthesia induction (T2) ~ at the end of operation (T5) (P<0.05). Compared with the control group, the serum levels of interleukin-6 (IL-6), tumor necrosis factor- α（TNF-α）, C reactive protein (CRP) in the study group were significantly lower at 1d after operation(P<0.05). Compared with the control group, the serum levels of hydrogen peroxide (H2O2) and malondialdehyde (MDA) in the study group were significantly lower ,antioxidant state (TAS) were significantly higher at 1 d after operation(P<0.05). The visual analogue scale (VAS) score of the study group was lower than that of the control group at 6 h and 12 h after operation (P<0.05). Ramsay Sedation scores of the study group at 6 h and 12 h after operation were higher than those of the control group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion: The sedative and analgesic effects of dextrometropidine hydrochloride combined with etomidate anesthesia in hysteroscopy are accurate, and have significant effects on maintaining hemodynamic stability, reducing inflammation and oxidative stress. |
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