小剂量右美托咪定对剖宫产术中镇静程度、血流动力学参数及术后氧化应激的影响

摘要

目的 探讨小剂量右美托咪定(DEX)对剖宫产术中镇静程度、血流动力学参数及术后氧化应激的影响.方法 收集2014年6月至2016年6月该院进行剖宫产分娩的产妇118例,按照随机数表法分为观察组(n=59)及对照组(n=59).胎儿娩出、断脐后,观察组产妇使用负荷剂量DEX(0.4 μg/kg,10 min静脉滴注),对照组在相同时间采用点静脉输注等容量生理盐水.DEX给药前(T0)、给药后10 min(T1)、腹壁缝合完毕时(T2)评估2组产妇的Ramsay镇静评分,使用运动心肺功能仪测定呼吸代谢指标,记录血流动力学参数,应用全自动生化分析仪测定血清氧化应激指标水平.结果 T1、T2时,观察组产妇Ramsay镇静评分值均高于对照组;呼吸代谢指标呼吸熵(RQ)、氧耗量(VO2)、二氧化碳排出量(VCO2)水平低于对照组;血流动力学参数收缩压(SBP)、舒张压(DBP)、心率(HR)水平低于对照组,差异均有统计学意义(P<0.05).术后6、12、24 h,观察组产妇血清氧化指标丙二醛(MDA)、脂质过氧化氢(LHP)、晚期蛋白氧化产物(AOPP)水平低于对照组,抗氧化指标谷胱甘肽过氧化物酶(GSH-Px)、总抗氧化能力(T-AOC)水平高于对照组,差异有统计学意义(P<0.05).结论 小剂量右美托咪定可增加剖宫产产妇的术中镇静程度、稳定血流动力学参数,减轻术后氧化应激损伤.%Objective To study the influence of low dose dexmedetomidine(DEX) on sedation depth,hemodynamic parameters during surgery and oxidative stress postoperation in cesarean section women.Methods 118 cases of cesarean section women in our hospital during June 2014 to June 2016 were collected and divided into observation group(n=59) and control group(n=59) according to random number table.Dexmedetomidine 0.4 μg/kg was intravenously infused over 10 min after fetal disengagement and Omphalotomy in observation group and the equal volume of normal Saline was given in control group.Amsay sedation score was evacuated at Dexmedetomidine before administration(T0),after administration of 10 min(T1),abdominal wall suture complete(T2),respiratory metabolism indices were tested by cardiopulmonary functioninstrument,hemodynamic parameters were readed on ECG monitor,serum oxidative stress levels were detected by automatic biochemical analyzer.Results At T1,T2 time point,Ramsay sedation score values were higher in observation group than those in control group;respiratory metabolism indices such as respiratory quotient(RQ),Oxygen consumption(VO2),carbon dioxide emission(VCO2) were lower in observation group than those in control group;hemodynamic parameters such as systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR) were lower in observation group than those in control group,the difference was statistically significant(P<0.05).6,12,24 h after cesarean section,serum oxidation indices such as malondialdehyde(MDA),lipid peroxide(LHP) and advanced oxidation protein products(AOPP) in observation group were lower than in control group,antioxidation indices such as Glutathione peroxidase(GSH-Px),total antioxidant capacity(T-AOC) levels in observation group were higher than those in control group,the difference was statistically significant(P<0.05).Conclusion Low dose dexmedetomidine can increase sedation depth,stable hemodynamic parameters during cesarean section in parturients,reduce oxidative stress injury after operation.