| 季红霞,张国华,张斌,等.右美托咪定联合艾司氯胺酮用于胸腔镜下肺癌根治术后镇痛效果及对血清白细胞介素 -1、P物质、前列腺素 E2和细胞间黏附分子 1的影响[J].安徽医药,2026,30(5):1044-1048. |
| 右美托咪定联合艾司氯胺酮用于胸腔镜下肺癌根治术后镇痛效果及对血清白细胞介素 -1、P物质、前列腺素 E2和细胞间黏附分子 1的影响 |
| Anesthetic effects of dexmedetomidine combined with esketamine on serum IL-1, SP, PGE2 and ICAM1 during thoracoscopic radical resection of lung cancer |
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| DOI：10.3969/j.issn.1009-6469.2026.05.040 |
| 中文关键词: 麻醉和镇痛 右美托咪定 艾司氯胺酮 胸腔镜下肺癌根治术 白细胞介素 -1 P物质 前列腺素 E2 细胞间黏附分子 1 |
| 英文关键词: Anesthesia and analgesia Dexmedetomidine Esketamine Thoracoscopic radical resection of lung cancer Inter. leukin-1 Substance P Prostaglandin E2 Intercellular adhesion molecule 1 |
| 基金项目:南通市卫生健康委员会项目( MSZ2023063) |
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| 中文摘要: |
| 目的探讨右美托咪定联合艾司氯胺酮在胸腔镜下肺癌根治术后镇痛效果以及对血清白细胞介素 -1(IL-1)、 P物质(SP)、前列腺素 E2(PGE2)和细胞间黏附分子 1(ICAM1)的影响。方法选择 2021年 1月至 2023年 8月南通市第六人民医院接受胸腔镜手术治疗的非小细胞肺癌( NSCLC)病人 98例作为研究对象，采用随机数字表法分为观察组和对照组，每组 49例。比较两组视觉模拟评分法( VAS)评分、 Ramsay镇静评分、平均动脉压( MAP)和心率( HR)、血氧饱和度( SpO2)、血清 IL-1β、SP、 PGE2、ICAM1水平。结果观察组术后 24 h、术后 48 h静息［( 2.24±0.47)分比( 2.75±0.48)分、［( 1.87±0.41)分比( 2.08±0.40)分］］及活动［( 2.76±0.53)分比( 3.35±0.56)分］、［( 2.06±0.43)分比( 2.35±0.48)分］时 VAS评分均低于对照组( P<0.05)；术后 6h［(2.32±0.69)分比(3.15±0.73)分］、 12 h［(2.45±0.65)分比( 3.24±0.75)分］24 h［(2.51±0.70)分比(3.12±0.59)分］观察组 Ramsay镇静评分均低于对照组( P<0.05)观察组 MAP与对照组比较，差异无统、计学意义( P>0.05)HR明显低于对照，组［( 63.89±11.32)次 /分比( 71.64±11.86)次 /分P<0.05］；术后 1d，观察组的血清 IL-1β、SP、PGE2、ICAM1水均明显低于对照组( P<0.05)，此外术后血清 SP、PGE2水平比术前升高(P<0.05)，ICAM1水平比术前下降(P<0.05)。结论艾司氯胺酮联合右美托咪定对胸腔镜下肺癌根治术病人具有很好的术后镇痛、镇静作用，能有效稳定血流动力学指标，降低血清 IL-1β、SP、PGE2、ICAM1水平，抑制炎症反应，且无明显不良反应，值得临床推广应用。平， |
| 英文摘要: |
| Objective To investigate the anesthetic effects of dexmedetomidine combined with esketamine during thoracoscopic radi.cal resection of lung cancer and its influence on serum Interleukin-1 (IL-1), Substance P (SP), prostaglandin E2 (PGE2), and intercellu. lar adhesion molecule 1 (ICAM1).Methods Ninety-eight patients with non-small cell lung cancer (NSCLC) who underwent thoraco.scopic surgery in The Sixth People's Hospital of Nantong City from January 2021 to August 2023 were randomly divided into observa.tion group and control group, with 49 cases in each group. VAS score, Ramsay sedation score, central venous pressure (MAP), heartrate (HR), blood oxygen saturation (SpO2), serum IL-1β, SP, PGE2 and ICAM1 levels were compared between the two groups.Results After surgery, the observation group exhibited lower VAS scores at rest [(2.24±0.47)point vs. (2.75±0.48)point, (1.87±0.41)point vs. (2.08±0.40)point] and during activity [(2.76±0.53)point vs. (3.35±0.56)point, (2.06±0.43)point vs. (2.35±0.48)point] compared to the control group at both 24h and 48h (P<0.05). At 6 hours [(2.32±0.69)point vs. (3.15±0.73)point], 12 hours [(2.45±0.65)point vs. (3.24± 0.75)point], and 24 hours [(2.51±0.70)point vs. (3.12±0.59)point] after surgery, the Ramsay sedation score was lower in the observation group compared to the control group (P<0.05). The observation group's MAP did not show a significant difference compared to the con. trol group (P>0.05), and the HR was significantly lower than that of the control group [(63.89±11.32)counts/minute vs. (71.64±11.86) counts/minute, P<0.05]. The levels of serum IL-1β, SP, PGE2, and ICAM1 were significantly lower in the observation group than those in the control group one day post-surgery (P<0.05), in addition, the levels of serum SP and PGE2 after surgery were higher than those be. fore surgery (P<0.05), and the levels of ICAM1 were lower than those before surgery (P<0.05).Conclusion The combination of esket. amine and dexmedetomidine provides effective postoperative pain relief and sedation for individuals undergoing thoracoscopic radicalsurgery for lung cancer, can effectively stabilize hemodynamic indexes, reduce serum IL-1β, SP, PGE2 and ICAM1 levels, inhibit in.flammatory response, and has no obvious adverse reactions, and is worthy of clinical promotion and application. |
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