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| 参麦注射液对老年患者肢体缺血-再灌注后肺损伤的影响 |
| Effect of Shenmai injection on pulmonary injury induced by lower extremity ischemia-reperfusion injury of senile patients |
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| DOI：10.12089/jca.2018.07.007 |
| 中文关键词: 参麦注射液 肺保护作用 缺血-再灌注损伤 |
| 英文关键词: Shenmai injection Lung protective effect Ischemia-reperfusion injury |
| 基金项目:南京市科技计划项目(201611004) |
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| 中文摘要: |
目的 观察参麦注射液对老年患者下肢手术中止血带引起的缺血-再灌注后肺损伤的影响。
方法 选择择期单侧下肢手术老年患者40例, 男24例, 女16例,年龄65～80岁,BMI 18.5～23.9 kg/m2,ASA Ⅱ 或 Ⅲ 级,按单盲法随机分为两组：参麦组(SM组)和对照组(C组),每组20例。两组患者均采用椎管-硬膜外联合麻醉。SM组于止血带充气前静脉滴注参麦注射液0.6 ml/kg(加入100 ml生理盐水中);C组于止血带充气前15 min静脉滴注生理盐水100 ml。分别于止血带充气前10 min(T0)、松止血带后5 min(T1)、松止血带后15 min(T2)和松止血带后30 min(T3)各时点采集两组患者的桡动脉血进行血气分析,记录并计算两组患者的PaO2、PaCO2、肺泡动脉血氧分压差(PA-aDO2)、呼吸指数(RI);并采集动脉血,测定并记录血浆血栓素B2(TXB2)和丙二醛(MDA)的浓度。
结果 与T0时比较,T2和T3时两组PA-aDO2明显升高(P<0.05),T2和T3时C组RI明显升高(P<0.05),T1-T3时两组TXB2和MDA浓度明显升高(P<0.05)。与C组比较,T2和T3时SM组PA-aDO2 和RI明显降低(P<0.05),TXB2和MDA浓度明显降低(P<0.05)。
结论 参麦注射液具有抗氧化作用,可以减轻老年患者下肢止血带引起的缺血-再灌注肺损伤。 |
| 英文摘要: |
Objective To investigate the effect of Shenmai injection on pulmonary injury induced by lower extremity ischemia-reperfusion injury of senile patients.
Methods Forty patients, 16 male, 24 female, aged 65 to 80, BMI 18.5 to 23.9 kg/m2, ASA physical status Ⅱ or Ⅲ, were randomly divided into Shenmai group and control group, 20 cases in each group. All patients were treated by combined spinal epidural anaesthesia. Patients in group SM were injected with Shenmai injection 0.6 ml/kg and physiological saline 100 ml, while patients in group C were injected with equal volume of normal saline instead 15 mins before tourniquet inflation. Blood samples used for blood gas analysis and measurement of plasma thromboxane B2 (TXB2) and malondialde-hyde (MDA) were taken from radial artery before tourniquet inflation (T0) and 5 min (T1), 15 min (T2), 30 min (T3) after tourniquet deflation, PaO2，PaCO2，PA-aDO2 and RI were calculated and recorded.
Results Compared with T0, PA-aDO2was significantly increased at T2 and T3 (P<0.05). Compared with T0, group C was significantly increased at T2 and T3 (P<0.05). From T1 to T3, TXB2 and MDA were significantly higher compared with T0 in the two groups. At T2 and T3, PA-aDO2 and RI in group SM were significantly lower than group C (P<0.05). TXB2 and MDA in group SM at T2 and T3 were significantly lower than those in group C(P<0.05).
Conclusion Shenmai injection has an antioxidation effect and improve on pulmonary injury induced by tourniquet induced ischemia-reperfusion injury of senile patients. |
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