Objective. Totally thoracoscopic cardiac surgery under cardiopulmonary bypass combined with one-lung ventilation has been identified as the trend in cardiac surgery. The aim of this study was to examine the effects of the selective α₂ adrenergic receptor agonist dexmedetomidine on the pulmonary function of patients who underwent mitral valve surgery using the totally thoracoscopic technique. Methods. Fifty-seven patients who underwent thoracoscopic mitral valve surgery between July 2019 and December 2019 were selected. The patients were randomly divided into the control (Con) group () and the dexmedetomidine (DEX) group () using the random number table method. Arterial blood gas analyses were performed, and the oxygenation (PaO₂/FiO₂) and respiratory indexes (P(A-a)O/PaO₂) were calculated 5 min after tracheal intubation (T1), 2 h after operation (T2), 6 h after operation (T3), and 24 h after operation (T4). Moreover, the serum cytokines interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and intercellular adhesion molecule-1 (ICAM-1) were detected using the enzyme-linked immunosorbent method at all time points. Chest radiography was performed 24 h after surgery. Peripheral blood samples were collected before and after the operation for a complete hemogram. Additionally, the procalcitonin concentration was measured and recorded when the patients were transported to the intensive care unit (ICU). The postoperative extubation time, length of ICU stay, and pulmonary infection rate were also recorded. Results. Inflammatory reaction after surgery was evident. However, the inflammatory cytokines IL-6, TNF-α, and ICAM-1 in the DEX group were lower than those in the Con group after surgery (T2 to T4; ). Neutrophil counts and procalcitonin concentration were higher in the Con group than in the DEX group (). In addition, in the DEX group, pulmonary exudation on chest radiography was lower, and pulmonary function, as shown by an increase in oxidation index and decrease in the respiratory index, improved after surgery (). Moreover, the duration of mechanical ventilation in the Con group was 3.4 h longer than that in the DEX group. Conclusion. Dexmedetomidine has a protective effect on pulmonary function in patients undergoing mitral valve surgery using a totally video-assisted thoracoscopic technique, which may be related to a reduction in the concentration of inflammatory cytokines in the early perioperative period.

中文翻译：

---

右美托咪定通过促进接受全胸腔镜心脏手术的患者的炎症消退来改善肺功能。

客观。体外循环联合单肺通气下的全胸腔镜心脏手术已被确定为心脏手术的发展趋势。本研究的目的是检查选择性α ₂肾上腺素能受体激动剂右美托咪定对使用全胸腔镜技术进行二尖瓣手术的患者肺功能的影响。方法。选择了 2019 年 7 月至 2019 年 12 月期间接受胸腔镜二尖瓣手术的 57 名患者。将患者随机分为对照组（Con）组（)和右美托咪定 (DEX) 组 ()使用随机数表法。进行动脉血气分析，_{气管插管后5} min （T1）、术后2 h（T2）_、6术后 h (T3) 和术后 24 h (T4)。此外，血清细胞因子白介素-6（IL-6）、肿瘤坏死因子-α（TNF -α)，在所有时间点均采用酶联免疫吸附法检测细胞间粘附分子-1 (ICAM-1)。术后 24 小时进行胸片检查。术前和术后采集外周血样进行完整的血象图。此外，当患者被运送到重症监护病房 (ICU) 时，测量并记录了降钙素原浓度。记录术后拔管时间、ICU停留时间和肺部感染率。结果。术后炎症反应明显。但DEX组术后炎性细胞因子IL-6、TNF- α、ICAM-1低于Con组（T2～T4；）。Con组的中性粒细胞计数和降钙素原浓度高于DEX组（）。此外，在 DEX 组中，胸片上的肺渗出物较少，并且肺功能（表现为氧化指数增加和呼吸指数降低）在术后有所改善。）。此外，Con 组的机械通气时间比 DEX 组长 3.4 h。结论。右美托咪定对全电视胸腔镜二尖瓣手术患者肺功能有保护作用，可能与围手术期早期炎性细胞因子浓度降低有关。