التفاصيل البيبلوغرافية
| العنوان: |
不同剂量右美托咪定混合罗哌卡因超声引导下 TPVB 联合全身麻醉对胸 腔镜下肺癌根治术患者应激反应、免疫功能和微转移的影响. (Chinese) |
| Alternate Title: |
Effects of Different Doses of Dexmedetomidine Mix with Ropivacaine Ultrasound-Guided TPVB Combine with General Anesthesia on Stress Response, Immune Function and Micrometastasis in Patients Undergoing Thoracoscopic Radical Resection of Lung Cancer. (English) |
| المؤلفون: |
唐月月, 袁从虎, 李向南, 纪月珑, 詹丹丹, 陈凤珍 |
| المصدر: |
Progress in Modern Biomedicine; 2024, Vol. 24 Issue 9, p1767-1772, 6p |
| Abstract (English): |
Objective: To investigate the effects of 0.5 μg/kg, 1.0 μg/kg, 1.5 μg/kg three doses of dexmedetomidine mix with ropivacaine ultrasound-guided thoracic paravertebral nerve block(TPVB) combine with general anesthesia on stress response, immune function and micrometastasis in patients undergoing thoracoscopic radical resection of lung cancer. Methods: 132 patients undergoing thoracoscopic radical resection of lung cancer in our hospital were selected, and patients were divided into high dose group (1.5 μg/kg dexmedetomidine combine with ropivacaine ultrasound-guided TPVB, 44 cases), middle dose group (1.0 μg/kg dexmedetomidine combine with ropivacaine ultrasound-guided TPVB, 44 cases) and low dose group (0.5 μg/kg dexmedetomidine combine with ropivacaine ultrasound-guided TPVB, 44 cases) according to the random number table. The recovery quality, hemodynamics [heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP)], stress response indexes [epinephrine (E), norepinephrine (NE), cortisol (Cor)], immune function [CD3+, CD4+, CD8+, CD4+/CD8+], micrometastasis [epidermal growth factor receptor messenger ribonucleic acid (EGFR mRNA), lung specific X protein (LUNX mRNA), cytokeratin 19 (CK19 mRNA)] and incidence of adverse reactions were compared in three groups. Results: The recovery time, tracheal extubation time and recovery room stay time in low dose group, middle dose group and high dose group were prolonged in turn(P<0.05). HR, SBP and DBP in low dose group, middle dose group and high dose group increased in turn at the time of tracheal extubation (T2) and 5 min after tracheal extubation (T3) (P<0.05). The levels of E, NE and Cor in low dose group, middle dose group and high dose group increased in turn at 48h after operation (P<0.05). CD8+ in low dose group, middle dose group and high dose group increased in turn, while CD3+, CD4+ and CD4+/CD8+ decreased in turn at 48 h after operation (P<0.05). EGFR mRNA, LUNX mRNA, and CK19 mRNA decreased at 48 h after surgery in the three groups, but there was no significant difference between the three groups.There was no difference in the incidence of adverse reactions in three groups(P>0.05). Conclusion: Dexmedetomidine combine with ropivacaine ultrasound-guided TPVB can effectively control the stress response of patients undergoing thoracoscopic radical resection of lung cancer, maintain hemodynamic fluctuations, reduce immunosuppression, and improve micrometastasis, the dose of 0.5 μg/kg is the best. [ABSTRACT FROM AUTHOR] |
| Abstract (Chinese): |
目的: 探讨0.5 μg/kg、1.0 μg/kg、1.5 μg/kg 三种剂量的右美托咪定混合罗哌卡因超声引导下胸椎旁神经阻滞 (TPVB) 联合全身麻醉对胸腔镜下肺癌根治术患者应激反应、免疫功能和微转移的影响。方法: 选取我院 132 例行胸腔镜下肺癌根治术的患者, 根据随机数字表法将132例患者随机分为高剂量组 (1.5 μg/kg的右美托咪定混合罗哌卡因超声引导下TPVB, 44例) 、中剂量组 (1.0 μg/kg 的右美托咪定混合罗哌卡因超声引导下TPVB, 44例) 和低剂量组 (0.5 μg/kg的右美托咪定混合罗哌卡因超声引导下TPVB, 44例) 。对比三组苏醒质量、血流动力学[心率 (HR) 、收缩压 (SBP) 、舒张压 (DBP) ]、应激反应指标[肾上腺素 (E) 、去甲肾上腺素 (NE) 、皮质醇 (Cor) ]、免疫功能 [CD3+、CD4+、CD8+, 计算CD4+/CD8+]、微转移[表皮生长因子受体信使核糖核酸 (EGFR mRNA) 、肺特异性X蛋白 (LUNX mRNA) 、细胞角蛋白19 (CK19 mRNA) ]、不良反应发生率。结果: 低剂量组、中剂量组、高剂量组的苏醒时间、气管拔管时间、恢复室停留时间依次延长 (P<0.05) 。低剂量组、中剂量组、高剂量组气管拔管时 (T2) 、气管拔管5 min时 (T3) 时间点HR、SBP、DBP依次升高 (P<0.05) 。低剂量组、中剂量组、高剂量组术后48 h E、NE、Cor依次升高 (P<0.05) 。低剂量组、中剂量组、高剂量组术后48 h CD8+依次升高, CD3+、CD4+、CD4+/CD8+ 依次下降 (P<0.05) 三组术后48 h EGFR mRNA、LUNX mRNA、CK19 mRNA下降, 但各组间无显著性差异。三组不良反应发生率组间对比未见差异 (P>0.05) 。结论: 右美托咪定联合罗哌卡因超声引导下TPVB可有效控制胸腔镜下肺癌根治术患者应激反应, 维持血流动力学稳定, 减轻免疫抑制, 改善微转移, 以0.5 μg/kg的剂量效果最佳。 [ABSTRACT FROM AUTHOR] |
|
Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
