七氟烷预处理对单肺通气下行肺叶切除患者的肺功能影响

发布时间：2018-12-08 09:07

【摘要】：[目的]探讨七氟烷预处理对单肺通气下行肺叶切除患者的肺功能影响[方法]严格按照筛选条件纳入肺叶切除术患者40例,将患者随机分为两组:七氟烷预处理组(S组,n=20),丙泊酚麻醉组(P组,n=20)。S组患者在全麻诱导插管后,给予1MAC七氟烷预处理30分钟,后停用七氟烷迅速气体交换,排净七氟烷;P组患者手术开始在单肺通气前泵注丙泊酚,余麻醉方案两组患者相同。在两组患者麻醉前(T0)、侧卧位双肺通气15分钟(T1),单肺通气30分钟(T2),单肺通气1小时(T3),结束单肺通气后30分钟(T4)、术后6小时(T5)及术后2天(T6)抽取血样,采用ELISA法检测Ⅱ型肺泡细胞表面抗原(Kreb Von den Lungen-6,KL-6)浓度,T1、T2、T3、T4时刻测定患者动态气道顺应性(Cdyn)。[结果]两组患者的一般情况(性别、年龄、身高、BMI、FEV1/FVC),单肺通气时间及手术时间差异均无统计学意义(p0.05)。两组患者Cdyn在T1时比较,差异无统计学意义(p0.05);与T1时比较,两组T2、T3时患者Cdyn显著降低,在T3达最低点,差异有统计学意义(p0.05);在T2、T3时,S组Cdyn明显高于P组,差异有统计学意义(p0.05)。两组患者T0、T1时的KL-6浓度比较差异无统计学意义(p0.05);与T1时相比较,T2、T3、T4、T5时血浆中KL-6浓度显著升高,差异有统计学意义(p0.05);与T5相比,两组T6时KL-6显著降低,差异有统计学意义(p0.05);在T2、T3、T4、T5、T6时,S组血浆KL-6水平明显低于P组,差异有统计学意义(p0.05)。[结论]七氟烷预处理肺叶切除单肺通气患者可以显著降低血浆中KL-6浓度升高水平,减轻肺顺应性降低程度,产生肺保护作用,减轻肺损伤程度。
[Abstract]:[objective] to investigate the effects of sevoflurane preconditioning on pulmonary function in patients undergoing lobectomy under single lung ventilation [methods] Forty patients with pulmonary lobectomy were included in the study according to the screening conditions, and the patients were randomly divided into two groups: sevoflurane preconditioning group (S group), and sevoflurane preconditioning group (S group). The patients in the propofol anesthesia group (group P, n = 20). S) were pretreated with 1MAC sevoflurane for 30 minutes after general anesthesia induction and intubation, and then stopped the rapid gas exchange of sevoflurane to remove sevoflurane. In group P, propofol was injected with propofol before single lung ventilation, and the rest of anesthesia was the same between the two groups. Before anesthesia (T0), 15 minutes (T 1), 30 minutes (T 2), 1 hour (T 3), 30 minutes (T 4) after unilateral ventilation were performed in both groups. Blood samples were collected 6 hours after operation (T5) and 2 days after operation (T6). The concentration of type 鈪，

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