右美托咪定在全麻腹腔镜胆囊切除术手术中对炎症因子、血浆D-二聚体、ATⅢ、FDP的影响

doi:10.3969/j.issn.2095-378X.2020.04.013

摘要/Abstract

摘要： 目的探讨右美托咪定（Dex）对全麻下腹腔镜胆囊切除术（LC）患者炎症因子、血浆D-二聚体（D-D）、抗凝血酶Ⅲ（ATⅢ）、纤维蛋白降解产物（FDP）的影响。方法选择实施LC手术的90例患者,采用随机数字表法分为试验组和对照组各45例,两组患者均采取全麻下LC手术,试验组于麻醉诱导前给予0.5 μg/kg的右美托咪定（Dex）,术中以0.25 μg/（kg·h）维持,对照组给予等量丙泊酚。结果术前,两组患者的血清CRP、IL-6、TNF-α水平差异无统计学意义（P>0.05）。术后12 h,试验组的血清CRP[（20.5±7.3） ng·L^–1]、IL-6[（26.7±9.5） ng·L^–1]、TNF-α[（3.08±1.64） μg·L^–1]均显著低于对照组CRP[（35.7±8.6） ng·L^–1]、IL-6[（43.8±11.6） ng·L^–1]、TNF-α[（5.29±1.86） μg·L^–1],差异有统计学意义（P<0.05）。术前,两组患者的血浆D-D、ATⅢ、FDP水平差异无统计学意义（P>0.05）。术后12 h,试验组的血浆D-D[（9.40±3.69） ng·L^–1]、FDP[（11.0±4.8） μg·mL^–1]水平显著低于对照组D-D[（14.71±5.50） ng·L^–1]、FDP[（16.8±5.5） μg·mL^–1]水平（P<0.05）,试验组术后ATⅢ水平[（89.6±9.8）%]高于对照组[（77.4±10.4）%],差异有统计学意义（P<0.05）。结论全麻下LC手术患者,加用Dex有利于减轻患者的炎症反应程度和手术对患者纤溶功能的影响。

关键词: 全麻, 腹腔镜胆囊切除术, 右美托咪定, 炎症因子

Abstract: Objective To investigate the effects of dexmedetomidine （Dex） on inflammatory factors, plasma D-dimer （D-D）, antithrombin Ⅲ （ATⅢ）,and fibrin degradation products （FDP） in patients undergoing laparoscopic cholecystectomy （LC） under general anesthesia. Methods Ninety patients undergoing LC were randomly divided into an experimental group （n=45） and a control group （n=45） with 45 cases each by random number table method. Both groups of patients underwent LC surgery under general anesthesia. The experimental group was given 0.5 μg/kg Dex before anesthesia induction and maintained at 0.25 μg/kg/h during the operation, and the control group was given the same amount of propofol. Results Before operation, there was no significant difference in serum CRP, IL-6 and TNF-α levels between the two groups （P>0.05）. At 12 h after operation, the levels of CRP [（20.5±7.3） ng·L^-1], IL-6 [（26.7±9.5） ng·L^-1] and TNF-α [（3.08±1.64） μg·L^-1] in the experimental group were significantly lower than those in the control group [（35.7±8.6） ng·L^-1], （43.8±11.6） ng·L^-1, and [（5.29±1.86） μg·L^-1 respectively] （P<0.05）. Before operation, there was no significant difference in plasma D-D, AT Ⅲ, and FDP levels between the two groups （P>0.05）; 12 h after operation,the levels of plasma D-D [（9.40±3.69） ng·L^-1] and FDP [（11.0±4.8） μg·mL^-1] in the experimental group were significantly lower than those in the control group [（14.71±5.50） ng·L^-1] and [（16.8±5.5） μg·mL^-1 respectively] （P<0.05）.The level of AT Ⅲ in the experimental group [（89.6±9.8）%] was significantly higher than that in the control group [（77.4±10.4）%] （P<0.05）. Conclusion In the patients with LC surgery under general anesthesia, the addition of Dex is beneficial to reduce inflammation and the effect of surgery on the fibrinolytic function of patients.

Key words: General anesthesia, Laparoscopic cholecystectomy, Dexmedetomidine, Inflammatory factors

中图分类号:

R614

钟文霞, 龙家棋, 曾建红, 李江梅, 李霜. 右美托咪定在全麻腹腔镜胆囊切除术手术中对炎症因子、血浆D-二聚体、ATⅢ、FDP的影响[J]. 外科研究与新技术, 2020, 9(4): 263-266.

ZHONG Wenxia, LONG Jiaqi, ZENG Jianhong, LI Jiangmei, LI Shuang. Effects of dexmedetomidine on inflammatory factors, plasma D-Dimer, ATⅢ, and FDP during laparoscopic cholecystectomy under general anesthesia[J]. Surgical Research and New Technique, 2020, 9(4): 263-266.

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