本文選題：肺腫瘤 + 右美托咪定�。� 參考：《山東醫(yī)藥》2017年29期

【摘要】：目的探討右美托咪定在肺癌患者開胸肺葉切除術中的應用效果。方法將擇期行開胸肺葉切除術的60例患者隨機均分為對照組與觀察組,觀察組于麻醉誘導前靜脈泵注0.6μg/kg右美托咪定10 min,對照組給予等量的生理鹽水泵注,誘導與麻醉方法相同。記錄兩組手術時間、單肺通氣時間及輸液量、失血量;于麻醉誘導前(T_0)、氣管插管前(T_1)、氣管插管后(T_2)、切皮時(T_3)、單肺通氣0.5 h(T_4)、單肺通氣1 h(T_5)及手術結束時(T_6)采集兩組動脈血,分析呼吸指數(shù)(RI)、氧合指數(shù)(OI)及肺血分流率(Qs/Qt);記錄上述各時間點末梢灌注指數(shù)(TPI)、低頻功率(LF)及高頻功率(HF);記錄上述各時間點心率變異性(HRV)、心率(HR)、收縮壓(SBP)及舒張壓(DBP)。結果兩組手術時間、單肺通氣時間、輸液量、失血量比較,P均0.05。與對照組相比,觀察組T_3~T_6時TPI值升高(P均0.05);T_4~T_5時RI、LF/HF、Qs/Qt降低,OI升高(P均0.05);與T_0比較,T_1~T_5時點兩組HRV、HR、SBP、DBP均降低,T_6時點觀察組HRV升高,對照組HRV、DBP升高(P均0.05);觀察組T_6時點SBP、DBP低于對照組(P均0.05)。結論靜脈泵注右美托咪定可減輕肺癌患者肺葉切除術中單肺通氣造成的肺損傷,改善患者微循環(huán),抑制圍術期手術刺激對心血管系統(tǒng)的干擾。
[Abstract]:Objective to evaluate the effect of dexmetomidine on lobectomy in patients with lung cancer. Methods Sixty patients undergoing open lobectomy were randomly divided into control group and observation group. The control group received 0.6 渭 g/kg dexmetomidine for 10 minutes before anesthesia induction, and the control group was given the same amount of normal saline pump as the anesthetic method. The time of operation, the time of single lung ventilation, the amount of transfusion and the amount of blood lost were recorded. Arterial blood was collected from two groups before anesthesia induction, before induction of anesthesia, before intubation, after intubation, after tracheal intubation, after endotracheal intubation, after tracheal intubation, at the time of skin incision, at T _ 3s, 0.5 h for one-lung ventilation, 1 h for T _ 5), 1 h for single lung ventilation and 1 h for T _ 5) and at the end of operation. Respiratory index (RI), oxygenation index (OI) and pulmonary blood shunt rate (Qs / QT) were analyzed. TPII index, low frequency power index (LFF) and high frequency power (HFV) were recorded at each time point. HRVV, HRV, SBP, SBP and DBP were recorded. Results the time of operation, the time of single lung ventilation, the volume of transfusion and the amount of blood loss were 0.05 in the two groups. Compared with the control group, the increase of TPI value in the observation group was 0.05% at the time of T4T _ (4) and T _ (5) in the observation group (P < 0.05), and the increase of TPI / QT in the two groups was lower than that in the control group (P < 0.05), and that in the observation group was lower than that in the control group at T _ (6) and T _ (6) (P < 0.05), and that in the observation group was lower than that in the control group (P < 0.05) at the T6 time point (P < 0.05), while in the observation group, it was significantly lower than that in the control group (P < 0.05) at the time point of T _ 6, compared with that in the control group at T _ (0) and T _ (1) T _ (5). Conclusion intravenous injection of dexmetidine can reduce lung injury caused by single lung ventilation in lung cancer patients, improve microcirculation and inhibit the interference of perioperative stimulation on cardiovascular system.
【作者單位】： 齊河縣人民醫(yī)院;國家手性制藥工程技術研究中心;
【分類號】：R734.2

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2 王付星;董方;;靜脈泵注右美托咪定在肺癌患者開胸肺葉切除術中的應用效果[J];山東醫(yī)藥;2017年29期

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5 尹秀茹;王鍵;梁佐迪;裴凌;;壓力控制容量保證通氣模式在阻塞性睡眠呼吸暫停綜合征肥胖患者中的應用[J];實用醫(yī)學雜志;2017年12期

6 許輝;疏樹華;王迪;章敏;柴小青;;目標導向液體治療單肺通氣肺癌根治術患者術中肺功能及中心靜脈血炎癥因子水平觀察[J];山東醫(yī)藥;2017年19期

7 黎敏;劉琳琳;鄧立平;華勝男;陳友偉;;右美托咪定聯(lián)合丙泊酚麻醉對老年骨折手術患者血流動力學及記憶力的影響[J];臨床醫(yī)學工程;2017年05期

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