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右美托咪定预处理对肝癌根治术患者肝脏缺血-再灌注损伤的影响
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| 篇名： | 右美托咪定预处理对肝癌根治术患者肝脏缺血-再灌注损伤的影响 |
| TITLE： | |
| 摘要： | 目的：探讨右美托咪定预处理对肝癌根治术患者肝脏缺血-再灌注损伤的影响。方法：40例择期行肝癌根治术患者随机分为对照组（20例）和观察组（20例）。术前，观察组患者给予盐酸右美托咪定注射液负荷剂量 0.7 μg/kg，10 min内输注完成，后以0.4 μg/（kg·h）维持，至手术结束；对照组患者给予与观察组同等剂量的0.9％氯化钠注射液，其余麻醉方案相同。观察两组患者术前及术后4、24、72 h时的丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、白细胞介素1（IL-1）、IL-6、C-反应蛋白（CRP）、肿瘤坏死因子α（TNF-α）水平及不良反应发生情况。结果：术前，两组患者不同时间点的AST、ALT、IL-1、IL-6、CRP、 TNF-α水平比较，差异均无统计学意义（P＞0.05）。术后，两组患者AST、ALT水平均显著高于同组术前，但观察组显著低于对照组，差异均有统计学意义（P＜0.05），且两组AST、ALT水平随时间延长逐渐降低。两组患者术后4、24、72 h IL-1、IL-6水平，术后4、24 h TNF-α水平及24、72 h CRP水平均显著高于同组术前，但观察组显著低于对照组；两组患者术后72 h TNF-α水平均显著低于同组术前，差异均有统计学意义（P＜0.05），且IL-1、IL-6、TNF-α水平随时间延长逐渐降低。两组患者不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：右美托咪定预处理能减轻肝癌根治术患者的肝脏缺血-再灌注损伤，降低炎症细胞因子水平，且未增加不良反应的发生。 |
| ABSTRACT： | OBJECTIVE： To investigate the effects of dexmedetomidine pretreatment on hepatic ischemia-reperfusion injury in patients with hepatocellular carcinoma radical surgery （HCRS）. METHODS： A total of 40 patients underwent elective HCRS were randomly divided into control group （20 cases） and observation group （20 cases）. Before operation， observation group was given Dexmedetomidine hydrochloride injection with loading dose of 0.7 μg/kg within 10 min， maintained at 0.4 μg/（kg·h） until the end of surgery. Control group was given constant volume of 0.9％ Sodium chloride injection as observation group and same anesthetic scheme. The levels of ALT， AST， IL-1， IL-6， CRP and TNF-α， the occurrence of ADR were observed in 2 groups before surgery， 4 h， 24 h， 72 h after surgery. RESULTS： Before surgery， there was no statistical significance in the levels of AST， ALT， IL-1， IL-6， CRP and TNF-α between 2 groups at different time points （P＞0.05）. After surgery， the levels of AST and ALT in 2 groups were significantly higher than before surgery， and the observation group was significantly lower than the control group， with statistical significance （P＜0.05）. The levels of AST and ALT in 2 groups were decreasing gradually as time. 4， 24， 72 h after surgery， the levels of IL-1 and IL-6 in 2 groups， TNF-α levels 4， 24 h after surgery and CRP levels 24， 72 h after surgery were significantly higher than before surgery， and the observation group was significantly lower than the control group； the levels of TNF-α in 2 groups 72 h after surgery were significantly lower than before surgery， with statistical significance （P＜0.05）. The levels of IL-1， IL-6 and TNF-α were decreasing gradually as time. There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： Dexmedeptomidine pretreatment can relieve hepatic ischemia-reperfusion injury in HCRS patients， reduce the level of inflammatory cells without increasing the occurrence of ADR. |
| 期刊： | 2017年第28卷第36期 |
| 作者： | 刘卫东，苏工，谢伟斌，夏瑜秦，蒋轶岭 |
| AUTHORS： | LIU Weidong，SU Gong，XIE Weibin，XIA Yuqin，JIANG Yiling |
| 关键字： | 右美托咪定；预处理；肝癌根治术；缺血-再灌注损伤 |
| KEYWORDS： | Dexmedetomidine； Pretreatment； Hepatocellular carcinoma radical surgery； Ischemia-reperfusion injury |
| 阅读数： | 256 次 |
| 本月下载数： | 1 次 |
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