氯胺酮对胸腔镜下肺叶切除病人围术期炎性细胞因子的影响

Effect of ketamine on inflammatory factors in pneumonectomy patients under VATS

目的:观察氯胺酮对胸腔镜下(VATS)肺叶切除单肺通气(OLV)病人围术期炎性细胞因子的影响。方法:拟行肺叶切除术肺癌病人30例,随机分为氯胺酮组(K组)和对照组(C组),每组各15例。两组患者分别在麻醉诱导后(T1)、OLV45 min(T2)、OLV90 min(T3)及术后2 h(T4)采取静脉血,测定血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、IL-8、IL-10浓度。结果:两组TNF-α、IL-6和IL-8于T2明显上升(P<0.05),IL-10于T3明显上升(P<0.05),K组T3、T4时TNF-α、IL-6和IL-8均明显低于C组(P<0.05),而IL-10高于C组(P<0.05)。结论:氯胺酮可减轻胸腔镜下肺叶切除病人肺的炎性因子的释放。

Objective： To observe the effect of ketamine on inflammatory factors in pneumonectomy patients under VATS. Methods： Thirty patients with lung cancer undergoing lung resection were randomly divided into 2 groups （ n = 15 each） ： ketamine group （group K） and control group （group C） . Blood samples were taken after induction of anesthesia （ T1, baseline） ; OLV 45 rain （T2 ） ; OLV 90 min （T3 ） and 2h after operation （ T4 ） for determination of serum TNF - or, IL - 6, IL - 8, concentrations. Results： Serum TNF - or, IL - 6 and IL - 8 concentrations were all significantly increased at T2 （ P 〈 0. 05 ） and Serum IL - 10 were increased at T3 （P 〈 0. 05 ） ; Serum TNF -α, IL - 6 and IL - 8 concentrations were lower at T3 - 4 and IL - 10 was higher in group K than group C （ P 〈 0. 05 ） . Conclusion ： Ketamine could alleviate the pulmonary inflammatory reactions in pneumonectomy patients under VATS.