本文選題：肺腫瘤 + 右美托咪定　； 參考：《山東醫(yī)藥》2017年29期

【摘要】：目的探討右美托咪定在肺癌患者開胸肺葉切除術(shù)中的應(yīng)用效果。方法將擇期行開胸肺葉切除術(shù)的60例患者隨機均分為對照組與觀察組,觀察組于麻醉誘導(dǎo)前靜脈泵注0.6μg/kg右美托咪定10 min,對照組給予等量的生理鹽水泵注,誘導(dǎo)與麻醉方法相同。記錄兩組手術(shù)時間、單肺通氣時間及輸液量、失血量;于麻醉誘導(dǎo)前(T_0)、氣管插管前(T_1)、氣管插管后(T_2)、切皮時(T_3)、單肺通氣0.5 h(T_4)、單肺通氣1 h(T_5)及手術(shù)結(jié)束時(T_6)采集兩組動脈血,分析呼吸指數(shù)(RI)、氧合指數(shù)(OI)及肺血分流率(Qs/Qt);記錄上述各時間點末梢灌注指數(shù)(TPI)、低頻功率(LF)及高頻功率(HF);記錄上述各時間點心率變異性(HRV)、心率(HR)、收縮壓(SBP)及舒張壓(DBP)。結(jié)果兩組手術(shù)時間、單肺通氣時間、輸液量、失血量比較,P均0.05。與對照組相比,觀察組T_3~T_6時TPI值升高(P均0.05);T_4~T_5時RI、LF/HF、Qs/Qt降低,OI升高(P均0.05);與T_0比較,T_1~T_5時點兩組HRV、HR、SBP、DBP均降低,T_6時點觀察組HRV升高,對照組HRV、DBP升高(P均0.05);觀察組T_6時點SBP、DBP低于對照組(P均0.05)。結(jié)論靜脈泵注右美托咪定可減輕肺癌患者肺葉切除術(shù)中單肺通氣造成的肺損傷,改善患者微循環(huán),抑制圍術(shù)期手術(shù)刺激對心血管系統(tǒng)的干擾。
[Abstract]:Objective to evaluate the effect of dexmetomidine on lobectomy in patients with lung cancer. Methods Sixty patients undergoing open lobectomy were randomly divided into control group and observation group. The control group received 0.6 渭 g/kg dexmetomidine for 10 minutes before anesthesia induction, and the control group was given the same amount of normal saline pump as the anesthetic method. The time of operation, the time of single lung ventilation, the amount of transfusion and the amount of blood lost were recorded. Arterial blood was collected from two groups before anesthesia induction, before induction of anesthesia, before intubation, after intubation, after tracheal intubation, after endotracheal intubation, after tracheal intubation, at the time of skin incision, at T _ 3s, 0.5 h for one-lung ventilation, 1 h for T _ 5), 1 h for single lung ventilation and 1 h for T _ 5) and at the end of operation. Respiratory index (RI), oxygenation index (OI) and pulmonary blood shunt rate (Qs / QT) were analyzed. TPII index, low frequency power index (LFF) and high frequency power (HFV) were recorded at each time point. HRVV, HRV, SBP, SBP and DBP were recorded. Results the time of operation, the time of single lung ventilation, the volume of transfusion and the amount of blood loss were 0.05 in the two groups. Compared with the control group, the increase of TPI value in the observation group was 0.05% at the time of T4T _ (4) and T _ (5) in the observation group (P < 0.05), and the increase of TPI / QT in the two groups was lower than that in the control group (P < 0.05), and that in the observation group was lower than that in the control group at T _ (6) and T _ (6) (P < 0.05), and that in the observation group was lower than that in the control group (P < 0.05) at the T6 time point (P < 0.05), while in the observation group, it was significantly lower than that in the control group (P < 0.05) at the time point of T _ 6, compared with that in the control group at T _ (0) and T _ (1) T _ (5). Conclusion intravenous injection of dexmetidine can reduce lung injury caused by single lung ventilation in lung cancer patients, improve microcirculation and inhibit the interference of perioperative stimulation on cardiovascular system.
【作者單位】： 齊河縣人民醫(yī)院;國家手性制藥工程技術(shù)研究中心;
【分類號】：R734.2

【參考文獻】

相關(guān)期刊論文 前9條

1 施春華;;全麻手術(shù)中應(yīng)用右美托咪定對患者藥物用量、應(yīng)激反應(yīng)與恢復(fù)期的影響[J];臨床合理用藥雜志;2016年33期

2 蘇瑞雪;李玉蘭;潘道剛;張楊;;單肺通氣中肺損傷及肺復(fù)張策略[J];臨床肺科雜志;2015年10期

3 王濤;楊曉明;王珊珊;;右美托咪定對全麻下脊柱手術(shù)患者術(shù)后寒顫的治療作用[J];川北醫(yī)學(xué)院學(xué)報;2015年02期

4 張莉;余鳴;;右美托咪定聯(lián)合芬太尼用于胸腹部惡性腫瘤患者術(shù)后躁動效果觀察[J];山東醫(yī)藥;2014年30期

5 王東昕;闞紅莉;于曉東;劉卓;;右美托咪定對肺癌根治術(shù)患者單肺通氣時的肺保護作用[J];中華麻醉學(xué)雜志;2014年06期

6 胡序凱;沈華春;李曉瑜;陳駿萍;;在單肺通氣期間不同通氣模式對患者的肺保護作用[J];中華醫(yī)學(xué)雜志;2014年13期

7 隋靜湖;鄧曉明;劉孝文;王玉慧;金錦花;魏靈欣;楊冬;;右美托咪定復(fù)合舒芬太尼清醒鎮(zhèn)靜在整形外科手術(shù)患者中的應(yīng)用[J];中華醫(yī)學(xué)雜志;2014年11期

8 萬海方;羅宏;汪國香;汪翼凡;曲丕盛;黃麗霞;陶凡;;Coopdech封堵支氣管導(dǎo)管用于胸椎結(jié)核患者經(jīng)胸入路手術(shù)單肺通氣麻醉的效果:隨機對照研究[J];中國全科醫(yī)學(xué);2014年03期

9 林飛;潘靈輝;楊建;錢衛(wèi);黃宇;杜學(xué)柯;;不同單肺通氣時間對大鼠肺組織中水通道蛋白1、4表達的影響[J];臨床麻醉學(xué)雜志;2013年01期

【共引文獻】

相關(guān)期刊論文 前10條

1 姚達;錢有輝;萬延輝;羅偉彬;吳國棟;;聯(lián)合應(yīng)用右美托咪定與遠隔缺血預(yù)處理對胸腔鏡肺部手術(shù)的肺保護作用及機制研究[J];河北醫(yī)科大學(xué)學(xué)報;2017年08期

2 王付星;董方;;靜脈泵注右美托咪定在肺癌患者開胸肺葉切除術(shù)中的應(yīng)用效果[J];山東醫(yī)藥;2017年29期

3 梁哲龍;張廣建;黃學(xué)洙;;右美托咪定輔助全麻對單肺通氣肺癌根治術(shù)患者血清IL-6、IL-8及IL-10的影響[J];中國現(xiàn)代藥物應(yīng)用;2017年14期

4 羅云梅;;胸外科單肺通氣手術(shù)封堵支氣管導(dǎo)管與雙腔氣管導(dǎo)管技術(shù)運用的臨床效果對比分析[J];浙江創(chuàng)傷外科;2017年03期

5 尹秀茹;王鍵;梁佐迪;裴凌;;壓力控制容量保證通氣模式在阻塞性睡眠呼吸暫停綜合征肥胖患者中的應(yīng)用[J];實用醫(yī)學(xué)雜志;2017年12期

6 許輝;疏樹華;王迪;章敏;柴小青;;目標導(dǎo)向液體治療單肺通氣肺癌根治術(shù)患者術(shù)中肺功能及中心靜脈血炎癥因子水平觀察[J];山東醫(yī)藥;2017年19期

7 黎敏;劉琳琳;鄧立平;華勝男;陳友偉;;右美托咪定聯(lián)合丙泊酚麻醉對老年骨折手術(shù)患者血流動力學(xué)及記憶力的影響[J];臨床醫(yī)學(xué)工程;2017年05期

8 劉召國;魯靖;瞿敏;張嬌玲;;右美托咪定復(fù)合舒芬太尼在局麻清創(chuàng)縫合術(shù)中的臨床應(yīng)用[J];中國衛(wèi)生標準管理;2017年13期

9 梁萬益;梁金華;陳偉志;;右美托咪定和曲馬多對預(yù)防椎管內(nèi)麻醉后寒顫的效果比較[J];臨床醫(yī)學(xué)工程;2017年04期

10 殷薇;;右美托咪定復(fù)合舒芬太尼用于整形手術(shù)的效果觀察[J];臨床醫(yī)藥實踐;2017年04期

【二級參考文獻】

相關(guān)期刊論文 前10條

1 李p，

本文編號：1818912