摘要
目的:探讨乌司他丁对食管癌根治术中单肺通气(OLV)肺损伤的保护作用。方法:全麻OLV下食管癌根治术患者60例,随机分为5组(n=12):对照组(R组),乌司他丁30万单位处理组(U1组),乌司他丁60万单位处理组(U2组),30万单位/4h乌司他丁持续泵入处理组(U3组),60万单位/4h乌司他丁持续泵入处理组(U4组)。单肺通气后注入等容量生理盐水、单次或者持续泵入乌司他丁。各组于单肺通气后、给药前(T0)、给药后1小时(T1)、2小时(T2)、4小时(T3)及术后1天(T4)抽取静脉血5ml,测定血浆中髓过氧化物酶(MPO)、肿瘤坏死因子α(TNF-α)和丙二醛(MDA)的含量。结果:在T1时间点,与R组比较,U1、U2、U3、U4组MPO、MDA、TNF-α含量下降(P<0.05),U2组较U1、U3、U4组下降更明显(P<0.05);在T2、T3时间点,U2、U3、U4组较U1、R组MPO、MDA、TNF-α含量下降明显(P<0.05),其中以U4组上述指标下降最显著,差异具有统计学差异(P<0.05);T4时间点各组间无明显差异(P>0.05)。结论:乌司他丁能显著降低食管癌根治术单肺通气患者血清MPO、MDA和TNF-α含量,在食管癌根治术OLV中发挥肺保护作用。
Objective：To explore the lung protective effect of ulinastatin on esophageal cancer resection during one-lung ventilation.Methods：Sixty esophageal cancer resection patients were divided into five groups randomly.Control group R （n=12）：the same volume of nomal saline as in other group in stead of ulinastatin.U1 group：ulinastatin 300000U intravenous infusion.U2 group：ulinastatin 600000U intravenous infusion.U3 group：ulinastatin 300000U intravenous infusion continually in four hours.U4 group：ulinastatin 600000U intravenous infusion continually in four hours.Blood concentrations of myeloperoxidase （MPO）,tumor necrosis factor （TNF）-α and malondialdehyde （MDA） were tested after one-lung ventilation and before dosage （T0）;one hour after one-lung ventilation （T1）;two hours after one-lung ventilation（T2）;four hours after one-lung ventilation（T3） and 1 day after operation （T4）.Results：At the time point of T1,compared with R group,there was decrease in MPO,MDA and TNF-α in other group （P〈0.05）.At T2 and T3,compared with R,U1 group,there was decrease in MPO,MDA and TNF-α in U2,U3 and U4 group,especially in U4 group （P〈0.05）.At T4,there was no differences in every group （P〉0.05）.Conclusion：Ulinastatin significantly decreased in patients with esophageal cancer resection OLV serum MPO,MDA and TNF-α,and play a protective role on the pulmonary injury in radical surgery for esophageal cancer during OLV.
出处
《现代肿瘤医学》
CAS
2014年第2期441-444,共4页
Journal of Modern Oncology
基金
国家自然科学基金(编号:30972833)
关键词
乌司他丁
单肺通气
肺损伤
肺保护
髓过氧化物酶
肿瘤坏死因子α
丙二醛
Ulinastatin
one-lung ventilation
pulmonary injury
lung protection effect
myeloproxidase
malondialdehyde
tumor necrosis factor-α
