肺保护性通气方案对老年原发性肺癌单肺通气患者脑组织炎性反应的影响

发布时间：2019-05-16 09:44

【摘要】：目的探讨肺保护性通气方案对老年原发性肺癌单肺通气患者脑组织炎性反应的影响。方法选取2016年5月至2017年5月无锡第二人民医院,江南大学附属医院和江阴市中医院三家医院收治的82例原发性肺癌患者,随机分为对照组与观察组,每组各41例。对照组给予容量控制通气策略,观察组给予容量控制通气结合肺保护性通气策略,抽取两组患者单肺通气前后及术后静脉血,测定血清炎性因子和神经胶质纤维酸性蛋白(GFAP)的浓度,抽取动脉血进行血气分析,采用旁气流法测定不同时间点呼吸力学参数指标,采用简易智力状态检查量表(MMSE)评分法评价认知功能,同时记录术后发生谵妄的情况。结果观察组T2、T3时点呼吸力学参数指标气道峰压(Ppeak)、平台压(Pplat)、Raw与对照组比较差异显著(P0.05)。T2~T4时点观察组血气分析参数指标氧分压(Pa O2)与对照组比较具有统计学意义(P0.05)。T3、T4时点观察组IL-6与对照组比较具有统计学意义(P0.05)。T2~T4时点观察组MMSE评分和谵妄发生率与对照组比较具有统计学意义(P0.05)。结论肺保护性通气策略对老年原发性肺癌单肺通气患者脑组织炎性反应有重要影响,可有效降低单肺通气时气道压力及阻力,减少炎症因子的释放,减轻炎症反应的发生。
[Abstract]:Objective to investigate the effect of pulmonary protective ventilation on inflammatory reaction of brain tissue in elderly patients with primary lung cancer. Methods 82 patients with primary lung cancer admitted to Wuxi second people's Hospital, Jiangnan University affiliated Hospital and Jiangyin traditional Chinese Medicine Hospital from May 2016 to May 2017 were randomly divided into control group (n = 41) and observation group (n = 41). The control group was given volume control ventilation strategy, the observation group was given volume control ventilation combined with lung protective ventilation strategy, and venous blood was taken before and after one lung ventilation in the two groups. The concentrations of serum inflammatory factors and glial fibrillar acidic protein (GFAP) were measured, arterial blood gas was taken for blood gas analysis, and respiratory mechanics parameters were measured by side air flow method at different time points. The cognitive function was evaluated by (MMSE) score method of simple mental state examination scale, and the occurrence of delirium after operation was recorded at the same time. Results in the observation group T2, T3 time point respiratory mechanics parameter index peak airway pressure (Ppeak), platform pressure (Pplat), There was significant difference in Raw between the observation group and the control group (P 0.05). The partial pressure of oxygen (Pa O 2) in the observation group was significantly higher than that in the control group at T2 ~ T 4 (P 0.05). T3, There was significant difference in IL-6 between the observation group and the control group (P 0.05). The MMSE score and delirium incidence in the observation group were significantly higher than those in the control group (P 0.05). Conclusion Pulmonary protective ventilation strategy has an important effect on the inflammatory reaction of brain tissue in elderly patients with primary lung cancer. It can effectively reduce airway pressure and resistance, reduce the release of inflammatory factors and reduce the occurrence of inflammatory reaction in elderly patients with primary lung cancer.
【作者单位】：江阴市中医院;江南大学附属医院;无锡市第二人民医院;
【分类号】：R734.2

【相似文献】