右美托咪定联合利多卡因静脉输注对腹腔镜全子宫切除术患者氧化应激水平及炎性反应的影响

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摘要目的探讨右美托咪定联合利多卡因对腹腔镜全子宫切除术患者氧化应激和炎性反应的影响。方法选取2014年9月~2017年10月宜宾市第一人民医院妇科全麻行腹腔镜全子宫切除术患者120例为研究对象，根据随机数字表法将其分为A、B、C组和对照组，各30例。A组予以右美托咪定联合利多卡因静脉泵注，B组予以右美托咪定静脉泵注，C组予以利多卡因静脉泵注，对照组予以生理盐水静脉泵注。于给药前（T1）、手术结束时（T2）、术后2 h（T3）和术后24 h （T4）对氧化应激指标[过氧化氢（H2O2）、丙二醛（MDA）、总抗氧化态（TAS）]及炎性因子[白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）]进行监测。比较四组术后不良反应发生率。结果在T2、T3、T4时，血清H2O2、MDA水平A组＜B组＜C组＜对照组，血清TAS水平A组＞B组＞C组＞对照组，组间比较差异有差异统计学意义（P ＜ 0.05）；血清IL-6、TNF-α水平A组＜B组＜C组＜对照组，组间比较差异有统计学意义（P ＜ 0.05）；A组恶心、呕吐发生率低于B组和对照组，差异有统计学意义（P ＜ 0.05）；A、B组嗜睡、心动过缓发生率高于C组和对照组，差异有统计学意义（P ＜ 0.05）。结论右美托咪定联合利多卡因可减轻腹腔镜全子宫切除术患者炎性反应和氧化应激反应，但术后嗜睡和心动过缓的发生率增加。

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	张努徐连生

关键词 ：右美托咪定, 利多卡因, 腹腔镜全子宫切除术, 氧化应激, 炎性反应

Abstract：Objective To expiore the effects of Dexmedetomidine combined with Lidocaine on oxidative stress and inflammatory response in patients with laparoscopic total hysterectomy. Methods One hundred and twenty patients with laparoscopic total hysterectomy in gynaecology of the First People′s Hospital of Yibin from September 2014 to October 2017 were selected as the subjects. According to the random digital table method,120 patients were divided into group A, B, C and control group, 30 cases in each group. Group A was treated with dexmedetomidin combined with Lidocaine by intravenous pump. Group B was treated with Dexmedetomidine by intravenous pump. Group C was treated with Lidocaine by intravenous pump. The control group treated with normal saline by intravenous pump. The inflammatory factors (IL-6, TNF-α) and oxidative stress indexes (H2O2, MDA and TAS) were monitored before administration (T1), at the end of operation (T2), 2 h after operation (T3) and 24 h after operation (T4). The incidence of postoperative adverse reactions was compared between the four groups. Results At T2, T3 and T4, levels of serum H2O2 and MDA, group A < group B< group C< control group, the difference between groups was statistically significant (P < 0.05). Levels of serum IL-6, TNF-α in group A < group B< group C< control group, and the TAS leves, group A> group B> group C> control group, the difference between groups was statistically significant (P < 0.05). The incidence of nausea and vomiting in group A was lower than that in group B and control group, the difference was statistically significant (P < 0.05). The incidence of somnolence and bradycardia in group A and B was higher than that in group C and control group, the difference was statistically significant (P < 0.05). Conclusion Dexmedetomidine combined with Lidocaine can alleviate the oxidative stress response and inflammatory response in patients with laparoscopic total hysterectomy. However, the incidence of somnolence and bradycardia increased after operation.

Key words： Dexmedetomidine Lidocaine Laparoscopic hysterectomy Oxidative stress Inflammatory response

引用本文:

张努徐连生. 右美托咪定联合利多卡因静脉输注对腹腔镜全子宫切除术患者氧化应激水平及炎性反应的影响[J]. 中国医药导报, 2018, 15(10): 95-98,134.
ZHANG Nu XU Liansheng. Effects of Dexmedetomidine combined with Lidocaine on oxidative stress and inflammatory response in laparoscopic hysterectomy patients. 中国医药导报, 2018, 15(10): 95-98,134.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2018/V15/I10/95

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