摘要
目的探讨多索茶碱对双腔气管插管单肺通气患者术中肺保护效应及其作用机制。方法将120例开胸肺叶切除术患者分为两组,研究组62例,对照组58例。两组均在双腔气管插管全身麻醉下进行单肺通气,研究组术中使用多索茶碱注射液进行干预,对照组使用等量生理盐水进行干预。全部患者于侧卧位后给药前即刻(T1)、单肺通气0.5 h(T2)、单肺通气1h(T3)测定呼吸动力指标(肺顺应性、气道阻力、气道平台压和气道峰压)、血气分析指标(PaO2、PaCO2)、氧化应激指标(MDA、SOD)、炎症指标(TNF-α、IL-6、IL-10),比较两组术后肺部并发症发生率的差异。结果T1时,两组呼吸动力指标、血气分析指标、氧化应激指标和炎症指标比较差异无统计学意义(P>0.05)。在T2~T3时,两组肺顺应性、PaO2、SOD较T1明显降低,气道阻力、气道平台压、气道峰压、PaCO2、MDA、IL-6、IL-10、TNF-α较T1明显增高,P<0.05。而在T2~T3时,研究组肺顺应性、PaO2、SOD、IL-10较对照组明显增高,气道阻力、气道平台压、气道峰压、PaCO2、MDA、IL-6、TNF-α较对照组明显降低,两组比较差异具有统计学意义(P<0.05)。研究组手术后肺部并发症发生率明显低于对照组,P<0.05。结论多索茶碱通过明显改善双腔气管插管单肺通气患者的肺氧合功能,降低肺部并发症的风险,从而发挥重要的术中肺保护效应,其作用机制可能与多索茶碱抗氧化应激、抗炎、扩张支气管和改善通气具有紧密的关系。
Objective To investigate the effects of doxofylline on intraoperative pulmonary protection and its mechanism in patients undergoing double lumen endotracheal intubation for one-lung ventilation.Methods 120 patients given pulmonary lobotomy were divided into two groups,62 cases in study group,58 cases in control group.Two groups underwent general anesthesia using double lumen endotracheal intubation for one-lung ventilation,the study group were used doxofylline injection for intervention,while the control group were used equal volume of normal saline for intervention.All patients of respiratory dynamics index(compliance of lung,resistance airway,pressure of platform,pressure of peak),blood gas analysis indexes(PaO2,PaCO2)and oxidative stress indicators(MDA,SOD),inflammation index(TNF-α,IL-6,IL-10)were detected immediately before administration(T1),at 30 min(T2),60 min(T3)after one-lung ventilation,the difference of postoperative pulmonary complications between the two groups were compared.Results At T1,there were no significant differences in respiratory dynamics,blood gas analysis,oxidative stress and inflammation indexes between the two groups(P>0.05),which were comparable.At T2~T3,compliance of lung,PaO2 and SOD in the two groups were significantly lower than T1,and resistance of airway,pressure of platform,pressure of peak,PaCO2,MDA,IL-6,IL-10 and TNF-αwere significantly higher than T1,P<0.05.At T2~T3,compliance of lung,PaO2,SOD,and IL-10 in the study group were significantly higher than those in the control group,and resistance of airway,pressure of platform,pressure of peak,PaCO2,MDA,IL-6,and TNF-αwere significantly lower than those in the control group(P<0.05).The incidence of pulmonary complications in the study group was significantly lower than that in the control group,P<0.05.Conclusion Doxofylline can significantly improve pulmonary oxygenation function,reduce the risk of pulmonary complications,thus play an important role on intraoperative pulmonary protection in patients undergoing double lumen en
作者
彭品
陆俊
方瑜
房明浩
Peng Pin;Lu Jun;Fang Yu;Fang Minghao(Department of Critical Medicine, Wuhan Yaxin General Hospital, Wuhan City 430000, Hubei Province, China;Department of Critical Medicine, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of science and technology, Wuhan City 430000, Hubei Province, China)
出处
《中华肺部疾病杂志（电子版）》
CAS
2020年第5期653-658,共6页
Chinese Journal of Lung Diseases(Electronic Edition)
关键词
多索茶碱
手术
气管插管
单肺通气
肺保护效应
Doxofylline
Operation
Tracheal intubation
One-lung ventilation
Pulmonary protection
