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医学临床研究  2023, Vol. 40 Issue (5): 695-698    DOI: 10.3969/j.issn.1671-7171.2023.05.016
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右美托咪定对胸腔镜肺结节手术患者短期预后和Th1/Th2平衡的影响
徐婷, 姚玉亮, 兰霞*
商洛市中心医院麻醉科,陕西 商洛 726000
Effects of Dexmedetomidine on Short-term Prognosis and Th1/Th2 Balance in Patients undergoing Thoracoscopic Pulmonary Nodule Surgery
XU Ting, YAO Yu-liang, LAN Xia
Department of Anesthesiology,Shangluo Central Hospital,Shangluo Shaanxi 726000
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摘要 【目的】探讨右美托咪定(Dex)对胸腔镜肺结节手术患者短期预后和Th1/Th2平衡的影响。【方法】在本院接受胸腔镜手术治疗的88例肺结节患者,随机分为观察组与对照组,每组44例。两组在全麻下行胸腔镜肺结节手术。观察组麻醉诱导前15 min静脉泵注Dex 0.5 μg/kg,术中持续泵注Dex 0.2~0.4 μg/(kg?h)。对照组泵注生理盐水代替Dex。两组术后均使用静脉自控镇痛泵。泵内药物:观察组舒芬太尼0.05 μg/(kg?h)+Dex 3.5 μg/kg,对照组舒芬太尼0.05 μg/(kg?h),均用生理盐水稀释至100 mL。比较两组血流动力学指标心排血量(CO)、平均动脉压(MAP)变化,手术前后两组Th1/Th2细胞因子白细胞介素-2(IL-2)、白细胞介素-4(IL-4)水平,苏醒质量、术后并发症以及安全性。【结果】两组术中2 h的CO、MAP水平均低于麻醉前(P<0.05),且观察组CO、MAP水平均低于对照组(P<0.05);两组麻醉前外周血IL-2、IL-4水平比较,差异无统计学意义(P>0.05),术后3 h,两组外周血IL-2水平高于麻醉前(P<0.05),且观察组显著高于对照组(P<0.05);两组IL-4水平低于麻醉前(P<0.05),且观察组显著低于对照组(P<0.05)。两组手术时间、苏醒时间比较,差异无统计学意义(P>0.05)。观察组并发症及治疗期间不良反应发生率均低于对照组(P<0.05)。【结论】Dex用于胸腔镜肺结节手术,可改善患者Th1/Th2免疫平衡,改善短期预后。
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徐婷
姚玉亮
兰霞
关键词 结节病,肺/外科学胸腔镜检查右美托咪定Th1细胞/血液Th2细胞/血液预后    
Abstract:【Objective】To investigate the effect of dexmedetomidine on short-term prognosis and Th1/Th2 balance in patients undergoing thoracoscopic pulmonary nodules. 【Methods】A total of 88 patients with pulmonary nodules admitted to our hospital were divided into the observationy group and the control group,with 44 cases in each group. Patients in two groups underwent thoracoscopic pulmonary nodule surgery with general anesthesia. In the observation group,dexmedetomidine 0.5 μg/kg was injected intravenously 15 minutes before induction of anesthesia and continuously pumped at 0.2-0.4 μg/(kg?h) intraoperative dexmedetomidine during the operation. The control group received normal saline instead of dexmedetomidine. After surgery,both groups used intravenous patient-controlled analgesia pump:sufentanyl 0.05 μg/(kg?h)+dexmedetomidine 3.5 μg/kg in the observation group and sufentanyl 0.05 μg/(kg?h) in the control group. These drugs were diluted in 100 mL of normal saline. The hemodynamic cardiac output (CO),mean arterial pressure (MAP) changes,Th1/Th2 cytokine,interleukin-2 (IL-2),interleukin-4 (IL-4) levels,quality of recovery,postoperative complications,and safety before and after surgery were compared in the two groups. 【Results】The levels of both CO and MAP at 2 h during the operation were lower than before anesthesia in the two groups (P<0.05). And levels of CO and MAP in the observation group were lower than those in the control group (P<0.05). There were no significant differences in IL-2 and IL-4 levels between the two groups before anesthesia (P> 0.05),however,at 3 h after the surgery, the peripheral blood IL-2 level was higher than those before surgery in both groups (P<0.05). And the IL-2 level in the observation group was significantly higher than that in the control group (P<0.05). Compared to pre-anesthesia,levels of IL-4 at 3 h after surgery in both groups were lower (P<0.05); And IL-4 level in the observation group was significantly lower than that in the control group (P<0.05). There was no significant difference in operation time and recovery time between the two groups (P>0.05). The incidence of complications and adverse reactions in the observation group were lower than those in the control group (P<0.05).【Conclusion】Dexmedetomidine in patients undergoing thoracoscopic pulmonary nodules surgery can improve the Th1/Th2 immune balance and improve the short-term outcome.
Key wordsSarcoidosis,Pulmonary/SU    Thoracoscopy    Dexmedetomidine    Th1 Cells/BL    Th2 Cells/BL    Prognosis
收稿日期: 2022-05-30     
中图分类号:  R563  
通讯作者: *E-mail:276600799@qq.com   
引用本文:   
徐婷, 姚玉亮, 兰霞. 右美托咪定对胸腔镜肺结节手术患者短期预后和Th1/Th2平衡的影响[J]. 医学临床研究, 2023, 40(5): 695-698.
XU Ting, YAO Yu-liang, LAN Xia. Effects of Dexmedetomidine on Short-term Prognosis and Th1/Th2 Balance in Patients undergoing Thoracoscopic Pulmonary Nodule Surgery. JOURNAL OF CLINICAL RESEARCH, 2023, 40(5): 695-698.
链接本文:  
http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.05.016     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I5/695
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