在接受单肺通风治疗的老年患者中,用德克斯梅德托米丁治疗肺损伤
1Department of Anesthesiology, Beijing Chest Hospital, Capital Medical University, China.
Archives of medical science : AMS
|September 21, 2023
概括
德克斯梅德托米丁 (DEX) 改善了老年患者的氧化和减少了肺损伤,这些患者接受了用单肺通风 (OLV) 进行胸切除术. DEX还减少了外科手术期间的呼吸道和心血管并发症,改善了患者的治疗结果.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 肺部医学 肺部医学
背景情况:
- 通过单肺通风 (OLV) 进行胸切除术的老年患者有肺损伤和术后并发症的风险.
- 德克斯梅德托米丁 (DEX) 是一种麻醉剂,具有潜在的器官保护作用.
研究的目的:
- 评估德克斯梅德托米丁 (DEX) 对肺损伤,氧化指数和外科手术期间肺部并发症的影响.
- 评估DEX对老年患者的影响,这些老年患者接受了OLV的胸腔切除术.
主要方法:
- 120名老年肺癌患者被随机分为两个组:DEX (n=60) 和对照组 (n=60).
- 在麻醉之前,DEX组接受了0.5μg/kg/h的DEX连续输注.
- 对照组接受了相同量的正常盐水.
主要成果:
- 与对照组相比,德克斯梅德托米丁组显示PaO2和pH增加,Qs/Qt下降.
- 德克斯的使用导致瘤亡因子-α和气管洗液中白血素6的水平降低.
- 接受DEX治疗的患者报告疼痛得分较低,镇静得分较高,呼吸和心血管事件较少.
结论:
- 在老年患者中,德克斯梅德托米丁有效地降低了肺内突变 (Qs/Qt),并在OLV期间改善了氧化 (PaO2).
- 通过减轻炎症反应,DEX显示出肺部保护作用.
- 使用DEX与术后呼吸道和心血管并发症的显著减少有关.
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