Objective:To determine whether dexmedetomidine (Dex) improves oxygenation and lung mechanics in patients with moderate chronic obstructive pulmonary disease (COPD) during lung cancer surgery.Methods:Fifty-six patients with moderate COPD were randomly allocated to a control group and a Dex group (n=28 each).In the Dex group,dexmedetomidine was given as an initial loading dose at 1.0 μg/kg lasting for 10 min followed by a maintenance dose at 0.5 μg/(kg-h) during OLV while the control group was administered an equal volume of 0.9% saline accordingly.Results:Patients in the Dex group had a significantly higher oxygenation index (P<0.05) and higher dynamic lung compliance at Dex-30 and Dex-60 (P<0.05) compared with those in the control group.In the Dex group,oxygenation index in the postoperative period was significantly higher (P=0.025) and postoperative complications were lower than those in the control group.Conclusion:Dex administration may provide dinically relevant benefits by improving oxygenation index and lung mechanics,and reducing postoperative pulmonary complications in patients with moderate COPD underwent lung cancer surgery.%目的:探索右美托咪定是否能改善合并中度慢性阻塞性肺疾病(chronic obstructive pulmonary disease,CORD)肺癌手术患者肺氧合作用和肺呼吸力学参数.方法:将56名合并有中度COPD的肺癌手术患者随机分配到对照组或Dex组(每组n=28).单肺通气期间,Dex组右美托咪定初始负荷剂量为1.0 μg/kg,微量泵注10 min,随后维持剂量改为0.5 μg/kg,持续泵注1h.对照组采用同样方法给予相同容量的0.9%生理盐水.结果:Dex-的氧合指数明显高于对照组(P<0.05),在Dex-30和Dex-60时肺动态顺应性明显增加(P<0.05).Dex组的术后氧合指数显著升高(P=0.025),术后并发症明显减少.结论:对合并有中度COPD的肺癌手术患者,右美托咪定能够提高肺氧合指数,改善肺呼吸力学参数和减少术后肺部并发症.
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