摘要
目的探讨雾化吸入对下肢手术病人肺换气功能的影响。方法选择术中需要上自动充气式止血带的单侧下肢手术患者25例,随机分为对照组14例和雾化吸入组11例。对照组术中上止血带按常规方法不接受任何其余处理,雾化吸入组在上止血带前15 min行雾化吸入(地塞米松5 mg+沐舒坦5 ml+生理盐水,共10 ml)。动态观察两组患者上止血带前(雾化吸入组为雾化吸入前)、松止血带后2 h、6 h、24 h 4个时间点动脉血气指标及血丙二醛(MDA)和内皮素-1(ET-1)的浓度变化。结果与上止血带前/雾化吸入前比较,对照组松止血带后6 h动脉血氧分压降低(PaO2),肺泡-动脉血氧分压差(PA-aDO2)和呼吸指数(RI)升高,血ET-1和MDA浓度升高(P<0.05或P<0.01),雾化吸入组各时点血气指标及血MDA和ET-1的浓度变化比较差异无统计学意义(P>0.05);与对照组比较,松止血带后6 h雾化吸入组PaO2较高,PA-aDO2、RI、血MDA和ET-1浓度较低(P<0.05或P<0.01)。结论雾化吸入治疗对下肢手术患者松止血带后的肺换气功能有明显改善作用,机制可能与其抑制氧自由基脂质过氧化和保护内皮细胞有关。
Objective To explore the effect of atomizing inhalation on pulmonary gas exchange in patients undergoing lower extremity surgery.Methods Twenty-five patients with unilateral lower extremity surgery were randomly divided into 2 groups： control group（n=14） and experimental group（n=11）.Patients in control group did not receive any treatment before tourniquet inflation,while those in experimental group were treated with atomizing inhalation（medicine inhaled including Dexamethasone 5 mg,Ambroxol 5 ml and normal saline） 15 min before tourniquet inflation.Blood samples for blood gas analysis and measurement of malondialdehyde（MDA） and endothelin-1（ET-1） were taken before tourniquet inflation and at 2,6,24 hours after tourniquet deflation.Results Compared with the baseline values at T0,in control group PaO2 at T2 was significantly decreased,while PA-aDO2 and RI,and the levels of MDA and ET-1 were significantly increased（P0.05 or P0.01）.And in experimental group,blood gas index,MDA and ET-1 did not have significant change after tourniquet deflation（P0.05）.Compared with control group,changes of PaO2,PA-aDO2,RI,MDA and ET-1 were significantly improved in experimental group（P0.05 or P0.01）.Conclusion Pulmonary gas exchange impairment induced by tourniquet application could be attenuated by inhalation therapy based on inhibiting lipid peroxidation and protecting endothelial cells.
出处
《护理学报》
2010年第20期44-47,共4页
Journal of Nursing（China）
基金
温州市鹿城科技计划项目(S090205)
关键词
下肢手术
肺换气功能
雾化吸入
止血带
护理
lower extremity surgery
pulmonary gas exchange
atomizing inhalation
tourniquet
nursing
