右美托咪定对脊柱手术患者围术期肝肾功能的影响

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1、授予单位代码10089学号或申请号20153328中国图书分类号R614HebeiMedicalUniversity硕士学位论文专业学位右美托咪定对脊柱手术患者围术期肝肾功能的影响研究生:刘欣导师:王秀丽教授专业:麻醉学二级学院:第三医院2018年3月目录中文摘要········································································································1英文摘要··············································

2、·················································2英文缩写·····························································································4研究论文右美托咪定对脊柱手术患者围术期肝肾功能的影响前言···········································································································5材料与

3、方法···························································································/6结果···································································································8附表························································································

4、··········9讨论····································································································13结论······························································································15参考文献······································································

5、··················15综述右美托咪定在临床麻醉中的应用·····················································18致谢············································································································27个人简历················································································

6、························28中文摘要右美托咪定对脊柱手术患者围术期肝肾功能的影响摘要目的:观察右美托咪定对脊柱手术患者围术期肝肾功能的影响。方法:自2016年12月至2017年5月，收集本院全麻下行腰后路减压植骨融合内固定术的患者60例，男31例，女29例，年龄49～78岁，BMI19～30kg/m2，ASAⅠ～Ⅲ级，采用随机数字表法分为两组(n=30):右美托咪定组(D组)和对照组(C组)，分别在麻醉诱导前给予0.5～1.0μg/kg右美托咪定与等量生理盐水，10min内泵注完毕。术中D组以0.2～0.5μg·kg-1·h-1的速度持续泵入右

7、美托咪定至手术结束前20min；C组泵入等量生理盐水方法同D组。分别于麻醉诱导前30min(T0)、手术结束时(T1)和术后2d(T2)3个时点抽取静脉血，测定血清中TNF-α、IL-6、IL-4、IL-10、CRP的浓度及胱抑素C(CysC)、血清肌酐(Cr)、尿素(UREA)、谷丙转氨酶(ALT)、谷草转氨酶(AST)水平，并比较两组患者住院时间和术后不良反应情况(心脑血管等不良事件)。结果:与T0时比较，T2时各炎性因子在术后第二天均显著升高，T1时两组ALT、AST、Cr、UREA水平均明显降低(P<0.05)；与C组比较，D组TNF-α、I