【摘要】：目的探討不同劑量羥考酮預(yù)處理對(duì)體外循環(huán)心臟手術(shù)患者血液動(dòng)力學(xué)及圍術(shù)期血清炎性因子的影響。方法選擇體外循環(huán)下?lián)衿谛呐K瓣膜置換術(shù)患者60例,采用隨機(jī)數(shù)字表法分為對(duì)照組、羥考酮低劑量組、羥考酮高劑量組,每組20例。羥考酮低、高劑量組麻醉誘導(dǎo)前5 min分別靜脈注射0.08、0.12 mg/kg鹽酸羥考酮注射液(5 mL),對(duì)照組靜脈注射等量生理鹽水。各組于預(yù)處理前(t_1)、體外循環(huán)開(kāi)始即刻(t_2)、體外循環(huán)結(jié)束(t_3)、手術(shù)結(jié)束(t_4)、手術(shù)后24 h(t_5),檢測(cè)收縮壓(SBP)、舒張壓(DBP)、平均動(dòng)脈壓(MAP)、HR等血流動(dòng)力學(xué)指標(biāo)及血清TNF-α、IL-6、IL-10等炎性因子指標(biāo)。結(jié)果三組t_2時(shí)SBP、DBP、MAP、HR均明顯低于t_1(P均0.05)。t_2、t_3時(shí)羥考酮低劑量組SBP、DBP、MAP高于羥考酮高劑量組和對(duì)照組(P均0.05),且羥考酮高劑量組高于對(duì)照組(P均0.05)。各組t_2、t_3、t_4、t_5時(shí)血清TNF-α、IL-6、IL-10水平均明顯高于t_1(P均0.05)。t_2、t_3、t_4、t_5時(shí),羥考酮低劑量組血清TNF-α、IL-6水平低于羥考酮高劑量組和對(duì)照組(P均0.05),血清IL-10水平高于羥考酮高劑量組和對(duì)照組(P均0.05);羥考酮高劑量組血清TNF-α、IL-6水平低于對(duì)照組(P均0.05),血清IL-10水平高于對(duì)照組(P0.05)。結(jié)論羥考酮預(yù)處理有助于維持體外循環(huán)心臟手術(shù)患者血流動(dòng)力穩(wěn)定,緩解全身炎癥狀態(tài),且0.08 mg/kg鹽酸羥考酮預(yù)處理效果更好。
[Abstract]:Objective to investigate the effects of different doses of hydroxycodone pretreatment on hemodynamics and perioperative inflammatory factors in patients undergoing cardiopulmonary bypass (CPB). Methods A total of 60 patients undergoing elective cardiac valve replacement under cardiopulmonary bypass were randomly divided into three groups: control group (n = 20), low dose group (n = 20) and high dose group (n = 20). In the high dose group, 0.08 mg/kg 0.12 mg/kg hydroxycodone hydrochloride injection was injected intravenously 5 min before anesthesia induction (5 mL), control group). Before preconditioning (t _ 1), at the beginning of cardiopulmonary bypass (t _ 2), at the end of cardiopulmonary bypass (t _ 3), at the end of surgery (t _ 4), 24 h after operation (t _ s _ 5), the systolic pressure (SBP),) and diastolic pressure (DBP),) were measured Mean arterial pressure (MAP), HR) and serum TNF- 偽, IL-6,IL-10 and other inflammatory factors. Results SBP,DBP,MAP,HR in the three groups was significantly lower than that in the control group (P < 0. 05), and the SBP,DBP,MAP in the low dose group was higher than that in the high dose group and the control group (both P 0. 05), and that in the low dose group was higher than that in the high dose group and the control group (P < 0. 05). And the high dose group of hydroxycodone was higher than the control group (P 0.05). The levels of serum TNF- 偽 and IL-6,IL-10 in each group were significantly higher than those in tti1 at the time of tipping, and the levels of serum TNF- 偽 and IL-6,IL-10 were significantly higher in each group than in the case of tit _ 2 / t _ 3s / s / s respectively. The levels of serum TNF- 偽 and IL-6 in the low dose group were lower than those in the high dose group and the control group (P 0.05), and the serum IL-10 level was higher than that in the high dose group and the control group (all P 0.05). The levels of serum TNF- 偽 and IL-6 in the high dose group were lower than those in the control group (P 0.05), and the level of serum IL-10 was higher than that in the control group (P0.05). Conclusion hydroxycodone pretreatment is helpful to maintain hemodynamic stability and relieve systemic inflammation in patients undergoing cardiopulmonary bypass (CPB) heart surgery, and 0.08 mg/kg hydroxycodone hydrochloride pretreatment is more effective.
【作者單位】： 安徽醫(yī)科大學(xué)附屬省立醫(yī)院;
【分類(lèi)號(hào)】：R654.2

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