摘要
目的 探讨尿胰蛋白酶抑制剂对单肺通气麻醉期间萎陷肺肺损伤的保护及作用机制.方法 选择单肺通气下食道癌开胸手术患者30例做为研究对象,ASAⅡ～Ⅲ级,随机分为对照（C组,n=15）和尿胰蛋白酶抑制剂组（U组,n=15）.尿胰蛋白酶抑制组给予尿胰蛋白酶抑制总量30万单位/100 mL在麻醉诱导后采用微量泵30 min输注完.对照组则输入100 mL生理盐水.分别于单肺通气前（T1）,单肺通气后1 h（T2）,单肺通气后2h （T3）以及手术结束（T4）4个时间点用纤维支气管镜行术侧肺叶灌洗.用ELISA法测定肺泡灌洗液中IL-6、IL-8及TNF-α含量的变化,并用瑞氏法染色进行支气管肺泡灌洗液（BALF）中中性粒细胞（PMN）计数.结果 与基础值T1相比,T3、T4对照组组与U组IL-6、IL-8、TNF-α含量及白细胞计数明显升高,但组间对比U组比C组升高低（P＜0.05）.结论 尿胰蛋白酶抑制剂对单肺通气期间萎陷肺的肺损伤具有一定的保护作用.
Objective To explore the protective effect of the urinary protease inhibitor on the collapsed lungs with one-lung anesthesia. Methods Thirty ASA II-Ul esophageal cancer patients with one-lung ventilation Undergoing open thoracic surgery were randomly divided into 2 greups（n=15 each）：control group （ group C ） and urinary protease inhibitor group （group U）.In group U, urinastatin was given total 300000U/100ml in 30 minutes adopting micro pump infusion after anesthesia induction.In group C,saline was given 100ml in 30 minutes. Bronchoalveolar lavage fluid samples were taken With fibereptic bronchoscopy by lavaging operation side lung before one-lung ventilition（T0,baseline）,at 1 hour after one-lung ventilition（T1,）, 2 hours after one-lung ventilition（T2）and the end of the surgery（T3）. IL-6, IL-8 and TNF-α concentrations were determined by EASIA methods and neutrephils were counted by using Rayleigh＇ s method.Results Compared with the baseline values at T0,IL-6, IL-8 TNF-α concentrations and neutrophils counts at T3, T4 were all significantly increased in group C and group U. but the IL-6, IL-8 , TNF-α concentrations and neutrephils counts were lower in group U than in group C （P〈0.05） .Conclusion Urinary protease inhibitor can protect the collapsed lungs with one-lung anesthesia.
出处
《中外医疗》
2013年第29期13-15,共3页
China & Foreign Medical Treatment
