国际麻醉学与复苏杂志   2019, Issue (6): 0-0
    
右美托咪定对恶性梗阻性黄疸患者肠黏膜屏障功能的影响
张远, 解雅英1()
1.内蒙古国际蒙医医院
Effects of dexmedetomidine on intestinal barrier function of malignant obstructive jaundice after surgery
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摘要:

目的 探讨右美托咪定(dexmedetomidine, Dex)对恶性梗阻性黄疸(malignant obstructive jaundice, MOJ)患者肠黏膜屏障功能(intestinal barrier function, IBF)的影响。 方法 40例MOJ行择期手术的患者,采用随机数字表法分为Dex组和对照组,每组20例。所有患者均采用全身静脉麻醉,其中Dex组在麻醉诱导前10 min以0.5 μg/kg负荷量静脉泵注Dex,术中以0.4 μg·kg-1·h-1持续泵注至术毕前20 min结束,对照组泵注等量生理盐水。术前(T1)、手术结束时(T2)、术后24 h(T3)和术后 48 h(T4)分别抽取静脉血,ELISA法检测血浆二胺氧化酶(diamine oxidase, DAO)浓度及PCR技术定性检测大肠杆菌DNA。 结果 两组患者T2~T4时点的血浆DAO浓度均高于T1时点,且T2~T4时点对照组血浆DAO浓度均明显高于Dex组(P<0.05)。T1时点两组患者大肠杆菌DNA检测结果均为阴性,T2~T4时点大肠杆菌DNA阳性例数依次增高(T2

关键词: 右美托咪定; 恶性梗阻性黄疸; 肠黏膜屏障
Abstract:

Objective To investigate the effects of dexmedetomidine (Dex) on intestinal barrier function (IBF) after surgery of patients with malignant obstructive jaundice (MOJ). Methods Forty patients with MOJ required for operation were selected, and were randomly divided into Dex group (n=20) and control group (n=20). All patients were anesthetized with general anesthesia. Dex group received intravenous infusion of Dex at a dose of 0.5 μg/kg 10 min before induction of anesthesia. In the course of surgery to 0.4 μg·kg-1·h-1 pump injection for 20 min before the completion of surgery. Control group was injected with the same volume of normal saline. Peripheral venous blood was sampled when the patients were in the operating room (T1), at the end of operation (T2), 24 h after operation (T3) and 48 h after operation (T4). The concentration of diamine oxidase (DAO) was measured by enzyme-linked immunosorbent assay (ELISA). Qualitative detection of Escherichia coli DNA was performed by polymerase chain reaction (PCR) technique. Results Two groups of plasma DAO levels in patients had no significant differences (P>0.05) at T1. However, control group was significantly higher than Dex group at T2, T3 and T4, and the difference was statistically significant (P<0.05). The Escherichia coli DNA test was negative at T1. From T2 to T4, the positive cases of Escherichia coli DNA was increased (T2

Key words: Dexmedetomidine; Malignant obstructive jaundice; Intestinal barrier