Résumé
[Objective]To explore the effects of dexmedetomidine on intrapulmonary shunt and inflammatory response in patients with one lung ventilation(OLV).[Methods] Fifty-six patients scheduled for radical resection of esophageal cancer were divided by random digits table method into dexmedetomidine group and control group with 28 cases each.Serum levels of interleukin(IL)-6,IL-8,tumor necrosis factor alpha(TNF- α)before openiαg the chest(To),at 30 min(T1)and 90 min(T2)after OLV,at 6 h(T3)and 24h(T4)after operation were detected and the intrapulmonary shunt fraction(Qs/Qt)was calculated.[Results]Compared with T0,serum levels ofTNF- α,IL-6 and IL-8 increased in both groups at T1-T4[dexmedetomidine group:(30.4 ± 4.7),(51.6 ± 7.8),(81.6 ± 7.6),(127.2 ± 16.8)ng/L vs.(19.7 ± 3.8)ng/L;(17.9 ± 4.4),(37.1 ± 9.6),(89.6 ± 12.9),(78.9 ± 13.1)ng/L vs.(15.0 ± 2.9)ng/L;(14.9 ± 2.2),(19.8 ± 3.3),(36.2 ±4.0),(35.8 ± 6.5)ng/L vs.(7.6 ± 1.4)ng/L;control group:(33.6 ±3.9),(79.8 ± 6.3),(101.5 ± 10.2),(145.3 ± 17.3)ng/L vs.(18.2 ±3.4)ng/L;(21.6 ±5.3),(46.9 ± 10.2),(112.5 ± 13.6),(106.2 ± 15.6)ng/L vs.(15.3 ±2.8)ng/L;(16.1 ±2.8),(26.3 ±4.7),(47.6 ±5.1),(40.2 ±6.2)ng/L vs.(8.3 ±2.0)ng/L],which had significant differences(P ＜ 0.01).There were statistical significance in the levels of TNF- α,IL-6 and IL-8 at T2-T4 between two groups(P ＜ 0.05).However,there was no statistical difference in Qs/Qt between two groups(P ＞ 0.05).[Conclusions] Perioperative continuous infusion of dexmedetomidine can reduce the inflammatory responses to a certain extent during OLV.But it has no obvious effects on intrapulmonary shunt.