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。
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.
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