• 临床研究 •

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

1. 河北省唐山市工人医院麻醉科, 河北 唐山 063000
• 收稿日期:2015-05-25 发布日期:2016-01-11
• 作者简介:刘红梅(1972-),女,河北省唐山市人,副主任医师,医学硕士,主要从事临床麻醉方面的研究。
• 基金资助:

河北省科技厅科技发展项目资助课题(20091748)

Influence of administration of dexmedetomidine before uterectomy in stress and immunologic function in patients

LIU Hongmei, YANG Li

1. Department of Anesthesiology, Worker's Hospital of Tanshan City, Hebei Province, Tangshan 063000, China
• Received:2015-05-25 Published:2016-01-11

Abstract:

Objective To explore the effect of dexmedetomidine on the stress and immunologic function in the patients undergoing uterectomy,and to provide an evidence for the medication in clinical anesthesia. Methods A total of 60 hysteromyoma patients who needed uterectomy were selected. All the patients were in ASAⅠ-Ⅱlevel.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 observation group were given dexmedetomidine (l μg·kg-1) with a concentration of 4 g·L-1 for 10 min,while the patients in control group were given equal normal saline.The induction was performed 10 min after infusion pump.Sevoflurane and fentanyl were used for maintaining during the anesthesia.The blood samples of the patients in two groups before entering the operation room (T0),2h after operation (T1),and extubation after operation (T2) were collected.The serum cortisol (COR) and interleukin-2 (IL-2) concentrations,plasma T lymphocyte subpopulations and NK levels were detected. Results The differences of COR and IL-2 concentrations at T0 between two groups were not statistically significant (P>0.05).The COR concentrations at T2 in two groups were significantly higher than those at T0 (P<0.05).The COR concentration at T2 in observation group was significantly lower than that in control group (P<0.05).The serum IL-2 concentration was gradually decreased with the prolongation of time observation in two groups.The serum IL-2 concentration in observation group was significantly higher than that in control group (P<0.05).The differences of CD3+,CD4+,CD8+,CD4+/ CD8+,and NK levels at T0 between two groups were not statistically significant (P>0.05).The differences of CD8+ level in each time point between two groups were not statistically significant (P>0.05).The CD3+,CD4+,CD4+/ CD8+,and NK levels at T1 and T2 in control group were significantly lower than those at T0 (P<0.05).The CD3+,CD4+,CD4+/ CD8+,and NK levels at T2 in observation group were significantly higher than those in control group (P<0.05). Conclusion Dexmedetomidine assisting anesthesia can alleviate the postoperative stress reaction,and reduce the effect of anesthesia and operation wound on the cellular immune function.It is beneficial for the postoperative rehabilitation.

• R614.2