|
| 多索茶碱在食管癌根治术中的肺保护作用 |
| Lung protective effect of doxofylline on radical surgery for esophageal cancer |
| |
| DOI： |
| 中文关键词: 甲基黄嘌呤 食管癌根治术 单肺通气 肺损伤 |
| 英文关键词: Methylxanthine Radical surgery for esophageal cancer One-lung ventilation Lung injury |
| 基金项目:安徽省蚌埠医学院研究生科研创新计划项目 (Byycxz1615) |
| 作者 | 单位 | E-mail | | 孟炎 | 233030,安徽省蚌埠市,蚌埠医学院第一附属医院麻醉科 | | | 朱芸 | 233030,安徽省蚌埠市,蚌埠医学院第一附属医院放射科 | | | 胡静 | 233030,安徽省蚌埠市,蚌埠医学院第一附属医院麻醉科 | | | 郑熙祥 | 233030,安徽省蚌埠市,蚌埠医学院第一附属医院麻醉科 | | | 李晓红 | 233030,安徽省蚌埠市,蚌埠医学院第一附属医院麻醉科 | lxh552@hotmail.com |
|
| 摘要点击次数: 2808 |
| 全文下载次数: 1575 |
| 中文摘要: |
| 目的 探讨多索茶碱对食管癌根治术患者所致肺损伤的保护作用。方法 选取择期全麻下行中下段食管癌根治术患者60例，男35例，女25例，年龄45～70岁，BMI 20～30 kg/m2，ASA Ⅰ或Ⅱ级，一秒用力呼气容积/用力肺活量（FEV1%）>50％。采用随机数字表法将患者分为两组:多索茶碱组 (D组)和对照组 (C组)，每组30例。两组常规静脉诱导后，予以右侧双腔支气管插管后机械通气。D组于双腔支气管插管后静脉滴注多索茶碱4 mg/kg， 30 min内滴注完毕，C组静脉滴注等量的生理盐水。在单肺通气（OLV）前10 min (T0)、OLV后60 min (T1)、双肺通气后 (T2)及手术结束 (T3)采集桡动脉血检测血清超氧化物歧化酶 (SOD)活性和TNF-α、IL-6、IL-10、丙二醛 (MDA)浓度，并检测各时点的血气。记录术中OLV时间、失血量、补液量和尿量，观察术后低氧血症、肺部炎症等不良反应的发生情况。结果 与T0时比较，T1～T3时两组血清SOD活性和PaO2明显降低，TNF-α、IL-6、IL-10和MDA浓度均明显升高 (P<0.05)。与C组比较，T1～T3时D组血清SOD活性和PaO2明显升高，TNF-α、IL-6、IL-10和MDA浓度明显降低 (P<0.05)。D组术后低氧血症和肺部炎症发生率明显低于C组 (P<0.05)。结论 多索茶碱可抑制食管癌根治术患者OLV后的炎症反应和氧化应激反应，降低术后低氧血症、肺部炎症的发生率，减轻食管癌根治术引发的肺损伤。 |
| 英文摘要: |
| Objective To discuss the protective effect of doxofylline on radical surgery for esophageal cancer. Methods Under elective general anesthesia, 60 cases, 35 males and 25 females, aged 45-70 years, BMI 20-30 kg/m2, ASA physical status Ⅰ or Ⅱ, FEV1%>50％, underwent radical surgery for esophageal cancer at middle and distal parts. Random number table was employed to divide these patients into two groups: doxofylline group (group D) and control group (group C) with 30 cases in each. After a routing intravenous induction in the two groups, mechanical ventilation was conducted after bronchial intubation with double channel catheter on the right side. The intravenous injection of doxofylline 4 mg/kg in group D was administrated 30 min after bronchial intubation with double channel catheter. Equal normal saline was instilled to the patients in group C. Blood samples were taken from radial artery to detect the levels of TNF-α, IL-6, IL-10, MDA and SOD at four time points: 10 min (T0) before the one-lung ventilation, 60 min after OLV (T1), after two-lung ventilation (T2) and the end of the operation (T3). Meanwhile, the blood and breath at these time points were tested. The occurrence of OLV, blood loss volumes, fluid input quantities, urine volumes, postoperative hyoxemia and pulmonary inflammation were observed. Results Compared with T0, the activity of SOD in serum and PaO2 in the two groups at T1-T3 decreased (P<0.05). The concentrations of TNF-α, IL-6, IL-10 and MDA increased significantly (P<0.05). Compared with group C, the activity of SOD activities and PaO2 in group D at T1-T3 increased while concentrations of TNF-α, IL-6, IL-10 and MDA decreased significantly (P<0.05). The occurrence rates of postoperative hyoxemia and pulmonary inflammation in group D were obviously lower than those in group C (P<0.05). Conclusion Doxofylline can suppress patients’ inflammatory response and oxidative stress response after OLV and reduce the incidence rates of postoperative hyoxemia and pulmonary inflammation as well as alleviate lung injury triggered by radical surgery for esophageal cancer. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
