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目的:探讨盐酸右美托咪定用于全凭静脉麻醉对子宫肌瘤切除术患者应激反应的影响。方法:选择我院收治的择期行子宫肌瘤切除术患者60例,随机分为观察组和对照组,每组30例。两组患者均采用全麻,其中观察组患者在麻醉诱导15 min内静脉输注1 ug/kg盐酸右美托咪定注射液,术中0.3-0.6 ug/(kg×h)维持;而对照组患者采用静脉输注0.9%的Nacl溶液。分别于麻醉前、麻醉后及苏醒期测定并观察两组患者外周静脉血中TNF-α,IL-2和IL-6的浓度变化情况。结果:两组患者麻醉前TNF-α,IL-2和IL-6的浓度无显著性差异(P>0.05)。两组患者麻醉后及苏醒期TNF-α,IL-2及IL-6浓度均显著高于麻醉前,差异具有统计学意义(P<0.05)。观察组患者麻醉后及苏醒期TNF-α,IL-2及IL-6浓度均显著低于对照组,差异具有统计学意义(P<0.05)。结论:右美托咪定用于全凭静脉麻醉对子宫肌瘤切除术患者血清TNF-α、IL-2和IL-6浓度具有调节作用,可缓解或降低手术引起的应激反应。
Objective: To investigate the effect of dexmedetomidine hydrochloride on stress response in patients with myomectomy by total intravenous anesthesia. Methods: Sixty patients with ectopic myomectomy undergoing elective resection in our hospital were randomly divided into observation group and control group, with 30 cases in each group. Patients in the observation group were given intravenous infusion of 1 ug / kg dexmedetomidine hydrochloride intravenously within 15 min after induction of anesthesia, and the patients in the observation group maintained 0.3-0.6 ug / (kg x h) intraoperatively. In the control group, Patients in the group received IV infusion of 0.9% Nacl solution. The levels of TNF-α, IL-2 and IL-6 in peripheral venous blood of two groups were measured before and after anesthesia and recovery. Results: There was no significant difference in the concentrations of TNF-α, IL-2 and IL-6 between the two groups before anesthesia (P> 0.05). The levels of TNF-α, IL-2 and IL-6 in both groups after anesthesia and recovery were significantly higher than those before anesthesia (P <0.05). The concentrations of TNF-α, IL-2 and IL-6 in the observation group were significantly lower than those in the control group after anesthesia and recovery (P <0.05). Conclusion: Dexmedetomidine is used in total intravenous anesthesia to regulate the concentration of serum TNF-α, IL-2 and IL-6 in patients with myomectomy, which can relieve or reduce the stress caused by surgery.