不同方式七氟烷处理对胸外科手术单肺通气患者氧化应激水平的影响

发布时间：2018-06-16 23:47

本文选题：七氟烷 + 单肺通气　；参考：《重庆医科大学学报》2015年03期

【摘要】：目的:探讨不同方式七氟烷处理对胸科手术单肺通气(one lung ventilation,OLV)患者氧化应激水平的影响。方法:胸科手术单肺通气患者80例,随机分为4组,即全凭静脉组(P组,丙泊酚及瑞芬太尼维持麻醉)、七氟烷预处理组(S1组,七氟烷吸入30 min后行OLV)、七氟烷后处理组(S2组,OLV后吸入七氟烷)、七氟烷全程吸入组(S3组,全程吸入七氟烷)。分别在麻醉诱导前(T0)、OLV前(七氟烷预处理30 min后)(T1)、OLV结束后30 min(七氟烷后处理30 min)(T2)和24 h(T3)采集桡动脉血。在T1和T2时间点同时取支气管肺泡灌洗液。采用化学比色法测定血清和支气管肺泡灌洗液丙二醛(malondialdehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)、乳酸脱氢酶(lactate dehydrogenase,LDH)、一氧化氮(nitric oxide,NO)含量及活性。结果:在OLV结束后30 min(T2)和24 h(T3),4组患者血清MDA、SOD、LDH、NO水平均较麻醉诱导前(T0)和OLV前(T1)高(P0.05),而七氟烷各组(S1、S2、S3组)的MDA、LDH、NO水平较全凭静脉组(P组)明显降低,SOD水平则明显增高(P0.05),S1、S2、S3组间无差异(P0.05)。在OLV结束后30 min(T2),4组患者支气管肺泡灌洗液中MDA、SOD、LDH、NO水平均较OLV前(T1)高(P0.05),但七氟烷各组(S1、S2、S3组)的MDA、LDH、NO水平较全凭静脉组(P组)明显降低,SOD水平则明显增强(P0.05),S1、S2、S3组间无差异(P0.05)。结论:不同时间七氟烷处理均能降低单肺通气患者血清和支气管肺泡灌洗液MDA、LDH和NO含量,增强SOD活性,提示七氟烷具有抗氧化应激损伤作用。
[Abstract]:Objective: to investigate the effect of sevoflurane treatment on oxidative stress in patients undergoing thoracic surgery with single lung ventilation (lung). Methods: eighty patients with single lung ventilation undergoing thoracic surgery were randomly divided into 4 groups: total intravenous group, propofol and remifentanil maintenance anesthesia group, sevoflurane preconditioning group and sevoflurane preconditioning group. Sevoflurane was inhaled for 30 min, sevoflurane was inhaled after OLV in S 2 group, and sevoflurane was inhaled in S3 group after sevoflurane inhalation. Radial artery blood was collected before induction of anesthesia (30 min after preconditioning of sevoflurane for 30 min) and 30 min (30 min after treatment with sevoflurane for 30 min) and 24 h after T3. Bronchoalveolar lavage fluid was taken simultaneously at T 1 and T 2 time points. The contents and activities of malondialdehyde (MDA), superoxide dismutase (SOD), lactate dehydrogenase (LDH), nitric oxide (no) in serum and bronchoalveolar lavage fluid (BALF) were measured by chemical colorimetry. Results: at 30 min after OLV termination, the levels of serum MDA-SODN LDHN in 4 groups were significantly higher than those before anesthesia induction (T0) and OLV (T1), while the levels of MDA-HLDHN in sevoflurane groups were significantly higher than those in the whole intravenous group (P). 30 min after the end of OLV, the level of no in the bronchoalveolar lavage fluid (MDA-SODN) was higher than that in the pre-OLV (T1) group (P < 0.05), but the level of MDA-LDHN in the sevoflurane group was significantly lower than that in the total intravenous group (P), but there was no significant difference between the two groups (P0.05). Conclusion: sevoflurane treatment at different time can decrease the contents of LDH and no in serum and bronchoalveolar lavage fluid of patients with single lung ventilation, and enhance the activity of SOD, suggesting that sevoflurane has the effect of anti-oxidative stress injury.
【作者单位】：重庆市第三人民医院麻醉科;重庆市第三人民医院胸外科;
【基金】：重庆市卫生局科研基金资助项目(编号:2012-2-217)
【分类号】：R614

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