摘要
目的探讨艾司洛尔对肺叶切除术患者全身炎症反应的影响。方法选取2017年8~12月在四川省人民医院行择期肺叶切除术患者40例,应用随机数表法分为对照组和艾司洛尔组,每组20例,分别在麻醉诱导后经静脉输注生理盐水和艾司洛尔溶液。检测麻醉诱导后5 min(T0)、单肺通气结束后5 min(T1)以及术后60 min(T2)时血中肿瘤坏死因子-α(TNF-α)及白介素-6(IL-6)含量;同时测量动脉血气,并计算氧合指数(OI)。结果 T0时,对照组患者的TNF-α、IL-6及OI分别(33.2±6.0)pg/mL、(11.0±2.3)pg/mL和(456.4±30.9)mm Hg,艾司洛尔组分别为(34.0±4.7)pg/mL、(11.3±1.5)pg/mL和(453.8±23.1)mm Hg,两组间比较差异均无统计学意义(P>0.05);T1时,对照组患者的TNF-α和IL-6分别为(52.9±4.4)pg/mL和(19.0±2.7)pg/mL,明显高于艾司洛尔组的(45.0±4.0)pg/mL、(16.3±1.5)pg/mL,差异均有统计学意义(P<0.05);T2时,对照组患者的TNF-α、IL-6分别为(49.1±4.5)pg/mL、(17.8±2.2)pg/mL,也明显高于艾司洛尔组的的(39.0±3.8)pg/mL、(15.1±1.3)pg/mL,差异均有统计学意义(P<0.05),对照组患者的OI为(351.5±20.2)mm Hg,明显低于艾司洛尔组的(372.0±16.7)mm Hg,差异有统计学意义(P<0.05)。结论艾司洛尔可减轻肺叶切除术患者炎症反应,提高术后早期肺氧合功能。
Objective To investigate the effect of esmolol on systemic inflammatory response in patients undergoing lobectomy. Methods From August 2017 to December 2017, forty patients who underwent elective lobectomy in Sichuan Provincial People＇s Hospital were randomly divided into control group and esmolol group according to random number table, with 20 patients in each group. After induction of anesthesia, patients in the esmolol group were infused with esmolol solution, while those in the control group were infused with the same volume of saline. The concentrations of tumor necrosis factor-α（TNF-α） and interleukin-6（IL-6） in the blood were measured at 5 min after induction of anesthesia（T0）, 5 min（T1） after end of one lung ventilation, and 60 min（T2） after operation. Arterial blood gas was measured at above time points, and the oxygenation index（OI） was calculated. Results At T0, the values of TNF-α, IL-6, and OI were（33.2±6.0） pg/mL,（11.0±2.3） pg/mL, and（456.4±30.9） mmH g in control group, respectively,versus（34.0±4.7） pg/mL,（11.3±1.5） pg/mL,（453.8±23.1） mmH g in esmolol group（P0.05）. At T1, the values of TNF-αand IL-6 were（52.9±4.4） pg/m L and（19.0±2.7） pg/m L in control group, significantly higher than（45.0±4.0） pg/m L and（16.3 ± 1.5） pg/m L in esmolol group（P0.05）. At T2, the values of TNF-α and IL-6 in the control group were（49.1±4.5） pg/m L and（17.8±2.2） pg/m L, significantly higher than（39.0±3.8） pg/m L and（15.1±1.3） pg/m L in esmolol group（P0.05）. Furthermore, the OI was（351.5±20.2） mm Hg in control group, significantly lower than（372.0±16.7） mm Hg in esmolol group（P0.05）. Conclusion Esmolol can reduce the inflammatory reaction in patients undergoing lobectomy and improve the early postoperative pulmonary oxygenation.
作者
吕强
万永灵
LV Qiang;WAN Yong-ling(Department of Anesthesiology,Sichuan Academy of Medical Sciences ＆ Sichuan Provincial People＇s Hospital,Chengdu 610072,Sichuan,CHINA)
出处
《海南医学》
CAS
2018年第16期2260-2262,共3页
Hainan Medical Journal
