七氟烷預(yù)處理對單肺通氣下行肺葉切除患者的肺功能影響
發(fā)布時間：2018-12-08 09:07
【摘要】：[目的]探討七氟烷預(yù)處理對單肺通氣下行肺葉切除患者的肺功能影響[方法]嚴格按照篩選條件納入肺葉切除術(shù)患者40例,將患者隨機分為兩組:七氟烷預(yù)處理組(S組,n=20),丙泊酚麻醉組(P組,n=20)。S組患者在全麻誘導(dǎo)插管后,給予1MAC七氟烷預(yù)處理30分鐘,后停用七氟烷迅速氣體交換,排凈七氟烷;P組患者手術(shù)開始在單肺通氣前泵注丙泊酚,余麻醉方案兩組患者相同。在兩組患者麻醉前(T0)、側(cè)臥位雙肺通氣15分鐘(T1),單肺通氣30分鐘(T2),單肺通氣1小時(T3),結(jié)束單肺通氣后30分鐘(T4)、術(shù)后6小時(T5)及術(shù)后2天(T6)抽取血樣,采用ELISA法檢測Ⅱ型肺泡細胞表面抗原(Kreb Von den Lungen-6,KL-6)濃度,T1、T2、T3、T4時刻測定患者動態(tài)氣道順應(yīng)性(Cdyn)。[結(jié)果]兩組患者的一般情況(性別、年齡、身高、BMI、FEV1/FVC),單肺通氣時間及手術(shù)時間差異均無統(tǒng)計學(xué)意義(p0.05)。兩組患者Cdyn在T1時比較,差異無統(tǒng)計學(xué)意義(p0.05);與T1時比較,兩組T2、T3時患者Cdyn顯著降低,在T3達最低點,差異有統(tǒng)計學(xué)意義(p0.05);在T2、T3時,S組Cdyn明顯高于P組,差異有統(tǒng)計學(xué)意義(p0.05)。兩組患者T0、T1時的KL-6濃度比較差異無統(tǒng)計學(xué)意義(p0.05);與T1時相比較,T2、T3、T4、T5時血漿中KL-6濃度顯著升高,差異有統(tǒng)計學(xué)意義(p0.05);與T5相比,兩組T6時KL-6顯著降低,差異有統(tǒng)計學(xué)意義(p0.05);在T2、T3、T4、T5、T6時,S組血漿KL-6水平明顯低于P組,差異有統(tǒng)計學(xué)意義(p0.05)。[結(jié)論]七氟烷預(yù)處理肺葉切除單肺通氣患者可以顯著降低血漿中KL-6濃度升高水平,減輕肺順應(yīng)性降低程度,產(chǎn)生肺保護作用,減輕肺損傷程度。
[Abstract]:[objective] to investigate the effects of sevoflurane preconditioning on pulmonary function in patients undergoing lobectomy under single lung ventilation [methods] Forty patients with pulmonary lobectomy were included in the study according to the screening conditions, and the patients were randomly divided into two groups: sevoflurane preconditioning group (S group), and sevoflurane preconditioning group (S group). The patients in the propofol anesthesia group (group P, n = 20). S) were pretreated with 1MAC sevoflurane for 30 minutes after general anesthesia induction and intubation, and then stopped the rapid gas exchange of sevoflurane to remove sevoflurane. In group P, propofol was injected with propofol before single lung ventilation, and the rest of anesthesia was the same between the two groups. Before anesthesia (T0), 15 minutes (T 1), 30 minutes (T 2), 1 hour (T 3), 30 minutes (T 4) after unilateral ventilation were performed in both groups. Blood samples were collected 6 hours after operation (T5) and 2 days after operation (T6). The concentration of type 鈪，
本文編號：2368087
[Abstract]:[objective] to investigate the effects of sevoflurane preconditioning on pulmonary function in patients undergoing lobectomy under single lung ventilation [methods] Forty patients with pulmonary lobectomy were included in the study according to the screening conditions, and the patients were randomly divided into two groups: sevoflurane preconditioning group (S group), and sevoflurane preconditioning group (S group). The patients in the propofol anesthesia group (group P, n = 20). S) were pretreated with 1MAC sevoflurane for 30 minutes after general anesthesia induction and intubation, and then stopped the rapid gas exchange of sevoflurane to remove sevoflurane. In group P, propofol was injected with propofol before single lung ventilation, and the rest of anesthesia was the same between the two groups. Before anesthesia (T0), 15 minutes (T 1), 30 minutes (T 2), 1 hour (T 3), 30 minutes (T 4) after unilateral ventilation were performed in both groups. Blood samples were collected 6 hours after operation (T5) and 2 days after operation (T6). The concentration of type 鈪，
本文編號：2368087
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