【摘要】：目的研究單肺通氣下行食管癌根治術(shù)中使用丙泊酚、七氟烷麻醉藥物對(duì)患者炎癥反應(yīng)及肺功能的影響,以降低感染率。方法選擇2011年4月-2013年4月在醫(yī)院接受食管癌根治手術(shù)的患者92例作為研究對(duì)象,根據(jù)數(shù)字法將患者隨機(jī)分成丙泊酚組與七氟烷組,各46例,對(duì)比兩組患者在不同時(shí)間點(diǎn)的肺泡-動(dòng)脈氧分壓差(PA-aO2)、氧合指數(shù)(OI)及呼吸指數(shù)(RI)水平,兩組患者在不同時(shí)間點(diǎn)的血漿白細(xì)胞介素-1(IL-1)及核轉(zhuǎn)錄因子KB(NF-kB)DNA結(jié)合活性水平以及圍手術(shù)期感染發(fā)生率。結(jié)果與氣管插管之后5min相比,七氟烷組患者通氣后30、60、90min的PA-aO2水平均增加,兩組患者通氣后30min至雙肺通氣時(shí)的OI水平均下降;與七氟烷組相比,丙泊酚組通氣后60min至手術(shù)結(jié)束時(shí)的RI水平均降低,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);七氟烷組手術(shù)結(jié)束時(shí)的血漿IL-1水平上升,丙泊酚組通氣后30、60min、恢復(fù)至雙肺通氣后10min及手術(shù)結(jié)束時(shí)的血漿IL-1水平顯著降低;與七氟烷組相比,丙泊酚組單肺通氣開始時(shí)及手術(shù)結(jié)束時(shí)的NF-kB DNA結(jié)合活性水平顯著下降,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);兩組患者圍手術(shù)期的感染率對(duì)比,差異無統(tǒng)計(jì)學(xué)意義。結(jié)論單肺通氣下實(shí)施食管癌根治手術(shù)時(shí)應(yīng)用丙泊酚麻醉,對(duì)患者的炎性反應(yīng)以及肺功能的影響更小,感染率亦較低,值得推廣應(yīng)用。
[Abstract]:Objective To study the effects of propofol and sevoflurane on the inflammatory response and lung function of patients with single-lung ventilation in the radical operation of esophageal cancer, to reduce the infection rate. Methods 92 patients who underwent radical operation in the hospital from April 2011 to April 2013 were randomly divided into propofol group and sevoflurane group according to the digital method,46 cases were divided into propofol group and sevoflurane group, and the partial pressure difference (PA-aO2) between the two groups at different time points was compared. The levels of oxygenation index (OI) and respiratory index (RI), plasma interleukin-1 (IL-1) and nuclear transcription factor KB (NF-kB) DNA binding activity in two groups at different time points and the incidence of perioperative infection. Results The levels of PA-aO2 at 30,60 and 90 min were increased in the group of sevoflurane compared with the 5 min after the tracheal intubation, and the level of OI decreased from 30 min to the double-lung ventilation in the two groups. Compared with the sevoflurane group, the RI level at the end of 60 min after ventilation of the propofol group and the end of the operation decreased, There was a significant difference in plasma IL-1 level at the end of operation of the sevoflurane group, the level of plasma IL-1 in the group of propofol group was 30 and 60 min, and the level of plasma IL-1 at the end of operation was significantly lower than that at the end of the operation; compared with the sevoflurane group, There was a significant difference in the level of NF-kB DNA binding activity at the beginning of single-lung ventilation and at the end of the operation (P0.05). Conclusion The application of propofol on the treatment of esophageal cancer under single-lung ventilation is less effective in the treatment of the inflammatory reaction and the function of the lung, and the infection rate is lower.
【作者單位】： 嘉興市第一醫(yī)院麻醉與疼痛醫(yī)學(xué)中心;
【基金】：嘉興市科技基金資助項(xiàng)目(2011AY1050-1)
【分類號(hào)】：R614;R735.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 萬梅方;辜曉嵐;魯振;顧連兵;;不同時(shí)間點(diǎn)應(yīng)用氟比洛芬酯對(duì)食管癌患者術(shù)后靜脈自控鎮(zhèn)痛效果的影響[J];中華實(shí)用診斷與治療雜志;2013年02期

【共引文獻(xiàn)】

相關(guān)期刊論文 前3條

1 孟朋民;楊泉林;蘇心鏡;;氟比洛芬酯超前鎮(zhèn)痛對(duì)無痛人工流產(chǎn)術(shù)麻醉效果及丙泊酚用量的影響[J];中國婦幼保健;2014年01期

2 孟朋民;楊泉林;蘇心鏡;;氟比洛芬酯超前鎮(zhèn)痛用于全憑靜脈麻醉下宮頸錐切術(shù)后疼痛的效果觀察[J];中國婦幼保健;2014年12期

3 謝秋媚;黃建華;孫岸靈;;七氟烷和丙泊酚對(duì)單肺通氣下行食管癌根治術(shù)患者炎癥反應(yīng)及肺功能的影響[J];現(xiàn)代醫(yī)院;2014年12期

相關(guān)碩士學(xué)位論文 前1條

1 盧伊芝;芬太尼復(fù)合氟比洛芬酯對(duì)乳腺癌根治術(shù)患者術(shù)后疼痛的影響[D];廣西醫(yī)科大學(xué);2014年

【二級(jí)參考文獻(xiàn)】

相關(guān)期刊論文 前3條

1 高琿;;開胸術(shù)后應(yīng)用氟比洛芬酯復(fù)合舒芬太尼鎮(zhèn)痛效果觀察[J];中華實(shí)用診斷與治療雜志;2010年12期

2 楊婷;姚尚龍;;舒芬太尼復(fù)合氟比洛芬酯用于開胸術(shù)后自控鎮(zhèn)痛的效果及安全性[J];中華實(shí)用診斷與治療雜志;2011年09期

3 段礪瑕,李曉玲;氟比洛芬酯注射液的藥理作用及臨床應(yīng)用[J];中國新藥雜志;2004年09期

【相似文獻(xiàn)】

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