比较单双肺通气对肺叶切除术围麻醉期氧自由基代谢的影响

Effect on the metabolism of oxygen free radical with one-lung Ventilation in lobectomy

目的:观察全身麻醉行肺叶切除术患者单肺机械通气(one-lung ventilation,OLV)和双肺机械通气(total-lung ventilation,TLV)不同通气模式下血黄嘌呤氧化酶(xanthine oxidase,XOD)、过氧化物酶(Myeloper-oxidase,MPO)活性改变和多形核白细胞(polymorphonuclear leucocyte,PMN)计数,了解OLV行肺叶切除术体内氧自由基代谢的情况。方法:肺癌行肺叶切除术患者20例,随机分为OLV实验组(A组)和TLV对照组(C组),每组10例。A组在手术开始后行OLV,手术结束恢复TLV;B组在手术开始后一直使用TLV。两组患者分别在术前(T0)、手术开始0.5h(T1)、1h(T2)、2h(T3)、手术结束后1h(T4)、2h(T5)、术后24h(T6)、48h(T7)8个时点采血行PMN计数,测XOD和MPO活性。结果:A组PMN计数升高较B组早,但两组间计数无显著性差异。A组XOD活性在OLV过程中升高,但两组间XOD活性无显著性差异。A组的MPO活性高于B组。结论:OLV较TLV行肺叶切除术围麻醉期有更多的氧自由基生成。

Objective：To compare the effect of one lung（OLV） and total lung ventilation （TLV） with lobectomy for the metabolism of oxygen free radical. Methods： Twenty lung cancer patients with lobectomy were classified in experiment group（ n = 10） and control group（ n = 10） （group A and group B）. Group A OLV lobectomy group and group B TLV lobectomy group. Patients in group A were ventilated with OLV when the operation began ;TLV was applied again when the operation was compeleted. In CG, TLV was used during the operative procedure only. Xanthineoxidase（XOD） and Myeloperoxidase （MPO） plasma activity were measured, and the polymorphonuclear leucocyte （PMN）were counted. Results： PMN was no difference in group A and group B. The activity of MPO in group A is more than group B. The activity of XOD was no difference in group A and group B. Conclusion： Lobectomy with OLV had a higher production of oxygen free radicals than TLV.