摘要
目的:对比分析肺癌手术治疗中应用双腔支气管插管(DLT)单肺通气(OLV)、单腔气管插管(ET)联合支气管封堵器(BB)的临床效果及对术中应激反应的影响。方法:回顾性分析2020年1月—2021年7月郑州市中心医院收治的130例行肺癌手术患者临床资料,根据麻醉方案不同将患者分为对照组和观察组,每组各65例。对照组采用DLT单肺通气麻醉,观察组采用ET联合BB (Coopdech)单肺通气麻醉。对比两组患者插管质量相关指标、麻醉前后应激反应指标[丙二醛(MDA)、还原型谷胱甘肽(GSH)、超氧化物歧化酶(SOD)水平]、成功单肺通气率及并发症风险。结果:观察组成功单肺通气率明显高于对照组,且并发症风险发生率明显低于对照组,差异有统计学意义(χ^(2)=3.900、5.849,P<0.05);观察组插管及双肺隔离时间、插管后心率(HR)明显低于对照组,而插管后平均动脉压(MAP)明显高于对照组,差异有统计学意义(t=15.019、5.700、5.894,P<0.05);麻醉后,两组患者MDA水平明显提高,且观察组明显低于对照组;GSH、SOD明显降低,且观察组明显高于对照组,差异有统计学意义(t=9.966、19.382、16.146,P<0.05)。结论:ET联合BB应用于肺癌手术治疗中临床效果显著,可有效提高成功单肺通气率,缩短插管及双肺隔离时间,降低术中应激反应及并发症风险。
Objective:To compare and analyze the clinical effects of using double-lumen bronchial tube(DLT)with single-lung ventilation(OLV)and single-lumen tracheal tube(ET)combined with bronchial blocker(BB)in the surgical treatment of lung cancer and the effect on intraoperative stress response.Methods:The clinical data of 130 patients admitted to the hospital for lung cancer surgery from January 2020 to July 2021 were retrospectively analyzed,and the patients were divided into control and observation groups according to different anesthesia protocols,with 65 cases in each group.The control group was anesthetized with DLT one-lung ventilation,and the observation group was anesthetized with ET combined with BB(Coopdech)one-lung ventilation.The indicators related to intubation quality,stress response indicators before and after anesthesia(malondialdehyde[MDA],reduced glutathione[GSH],superoxide dismutase[SOD]levels),successful one-lung ventilation rate and risk of complications were compared between the two groups.Results:The successful single-lung ventilation rate of the observation group was significantly higher than that of the control group,and the risk of complications was significantly lower than that of the control group,with statistically significant differences(χ^(2)=3.900,5.849,P<0.05).The intubation and double-lung isolation time and post-intubation HR in the observation group were significantly less than those in the control group,while the post-intubation MAP was significantly higher than that in the control group,with statistically significant differences(t=15.019,5.700,5.894,P<0.05).After anesthesia,MDA levels were significantly higher in both groups and significantly lower in the observation group than in the control group,and GSH and SOD were significantly lower and significantly higher in the observation group than in the control group,with statistically significant differences(t=9.966,19.382,16.146,P<0.05).Conclusion:ET combined with BB is clinically effective in the surgical treatment of lung cancer,eff
作者
卜亚楠
陈秋
Bu Yanan;Chen Qiu(Department of Anesthesia and Perioperative Medicine,Zhengzhou Central Hospital,Zhengzhou,Henan,450000,China)
出处
《黑龙江医学》
2023年第13期1574-1576,共3页
Heilongjiang Medical Journal
基金
河南省医学科技攻关项目(201801112)。
关键词
双腔支气管插管
单腔气管插管
封堵器
单肺通气麻醉
肺癌手术
应激反应
Double-lumen bronchial intubation
Single-lumen tracheal intubation
Blocker
One-lung ventilation anesthesia
Lung cancer surgery
Stress reaction
