本文選題：右美托咪定 + 食管腫瘤��； 參考：《中國新藥與臨床雜志》2015年11期

【摘要】：目的探討右美托咪定(Dex)對微創(chuàng)Mc Keown食管癌根治術(shù)患者術(shù)中尿量的影響及其機制。方法擇期行微創(chuàng)Mc Keown食管癌根治術(shù)的患者60例(ASAⅠ~Ⅱ級),隨機分為3組,每組20例。Dex1組、Dex2組麻醉誘導(dǎo)前,予Dex 1μg·kg-1靜脈泵注,15 min泵完,后以0.2、0.4μg·kg-1·h-1維持至手術(shù)結(jié)束;對照組予等量氯化鈉注射液靜脈泵注。術(shù)中監(jiān)測患者生命體征,記錄每小時尿量,采用放射免疫法測定6個時點(術(shù)前,術(shù)中1、2、3 h,術(shù)畢,術(shù)后2 h)血漿抗利尿激素(ADH)、醛固酮(ALD)、心房鈉尿肽(ANP)濃度。結(jié)果 Dex1組、Dex2組患者尿量從術(shù)中2 h開始增高,且Dex2組增高程度高于Dex1組(P0.05)。3組血漿ADH濃度圍術(shù)期均無明顯變化,術(shù)中1 h Dex1組、Dex2組血漿ALD濃度開始下降,低于術(shù)前和對照組(P0.05),Dex1組、Dex2組間各時點無顯著差異(P0.05)。Dex1組、Dex2組血漿ANP濃度從術(shù)中1 h起增高,術(shù)中3 h達高峰,術(shù)中各時點均高于對照組(P0.05),兩組之間各時點均無顯著差異(P0.05)。結(jié)論 Dex應(yīng)用于微創(chuàng)Mc Keown食管癌根治術(shù)患者具有利尿作用,可能通過抑制腎素-血管緊張素-醛固酮系統(tǒng)和增加ANP釋放使患者尿量增加。
[Abstract]:Objective to investigate the effect and mechanism of dexmetomidine Dexon on urine volume in patients undergoing minimally invasive Mc Keown radical resection of esophageal carcinoma. Methods Sixty patients undergoing minimally invasive Mc Keown radical resection of esophageal carcinoma were randomly divided into 3 groups. 20 cases in each group were given Dex 1 渭 g kg-1 infusion 15 min before anesthesia induction, and then maintained with 0.2 渭 g kg-1 h-1 until the end of the operation. The control group received the same amount of sodium chloride injection intravenous pump. Vital signs were monitored and urine volume per hour was recorded. Plasma antidiuretic hormone (ADH), aldosterone (ALD) and atrial natriuretic peptide (ANPs) were measured at 6 time points (preoperative, intraoperative 2 h, postoperative 2 h) by radioimmunoassay. Results the urine volume in Dex1 group was increased from 2 hours after operation, and the level of plasma ADH in Dex2 group was higher than that in Dex1 group (P 0.05). The plasma ALD concentration in Dex1 group began to decrease 1 h after operation. There was no significant difference in plasma ANP concentration between Dex2 group and control group. Plasma ANP concentration in Dex2 group increased from 1 hour during operation, reached the peak at 3 h during operation, and was higher than that in control group (P 0.05) at each time point. There was no significant difference between the two groups at each time point. Conclusion Dex has diuretic effect in patients undergoing minimally invasive Mc Keown radical resection of esophageal cancer. It may increase urine volume by inhibiting renin-angiotensin-aldosterone system and increasing ANP release.
【作者單位】： 溫州醫(yī)科大學(xué)附屬第一醫(yī)院麻醉科;
【分類號】：R614;R735.1

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本文編號：1990644