子宫切除术前给予右美托咪定对患者应激和免疫功能的影响_刘红梅.pdfVIP

医药前沿投稿网址 [文章编号] DOI 子宫切除术前给予右美托咪定对患者应激和免疫功能的影响 刘红梅 杨莉 （河北省唐山市工人医院 063000） [摘 要] 目的：探讨右美托咪定对子宫切除术患者应激及免疫功能的影响，旨在为临床麻醉用药提供依据。 方法：选取子宫肌瘤且需行择期子宫切除术患者60 例，ASA I-II 级，依据预输注药物不同分为观察组与 对照组，各30 例，观察组患者麻醉前给予负荷剂量右美托咪定静脉泵注，剂量lμg/kg，浓度4μg/mL，泵 注时间10min，对照组患者给予等量生理盐水泵注；两组均在泵注10min 后开始诱导，麻醉中两组均使用 七氟醚和芬太尼维持；两组患者于入室前（T0 ）、手术2h （T1 ）、术后拔管时（T2 ）采血，检测血清皮质 醇(COR)、白介素-2 （IL-2 ）浓度，并检测血浆T 淋巴亚群和 NK 细胞水平变化。结果：两组T0 时血清 COR、IL-2 浓度比较无统计学差异（P0.05 ）；两组T2 时COR 浓度显著高于 T0 时（P0.05 ）；观察组 T2 时COR 浓度显著低于对照组（P0.05 ）；两组随手术时间延长血清IL-2 浓度呈下降趋势，对照组 T2 时血清IL-2 浓度显著低于观察组（P0.05 ）；两组T0 时CD3+、CD4+、CD8+、CD4+/ CD8+、NK 水平 比较无统计学差异（P0.05 ）；两组各时间点CD8+水平比较无统计学差异（P0.05 ）；对照组患者T1、T2 时CD3+、CD4+、CD4+/ CD8+、NK 水平均显著低于T0 时（P0.05 ）；C 组T2 时CD3+、CD4+、CD4+/ CD8+、NK 水平均显著高于对照组（P0.05 ）。结论：右美托咪定辅助麻醉可减轻患者术后应激反应，降 低麻醉及手术创伤对机体细胞免疫功能的影响，利于患者术后康复。 [关键词] 子宫切除术；右美托咪定；COR；IL-2 ；T 淋巴细胞亚群 [中图分类号] R736 [文献标志码] A The effect of administration of dexmedetomidine prior to ut erectomy on the stress and immunologic function in patient s Hongmei Liu, （Worker ’s Hospital of Tanshan City in Hebei Province, 063000 ） Abstract: Objective：The present study is to explore the effect of dexmedetomidine on the stress and immunologic function in patients who was given uterectomy, so as to provide an evidence for the medication in clinical anesthesia. Methods: A total of 60 hysteromyoma patients who need uterectomy were selected . All the patients were in ASAI-II level. The patients were divided into observation group (n=30) and control group (n=30) according to administration of different types of drugs. Before anesthesia, the patients in the observation group were given dexmedetomidine (lμg/kg) with a concentration of 4μg/mL for 10 min, while the patients in the control group wer