高频喷射通气对单肺通气患者氧化应激反应的影响

Effects of high-frequency jet ventilation on oxidative stress in patients during one lung ventilation

目的 研究高频喷射通气（HFJV）对单肺通气患者氧化应激反应的影响.方法 择期行食管癌根治术患者45例,按随机数字表法分为双肺通气组（A组）、单肺通气组（B组）、单肺通气时非通气侧给予HFJV（驱动压力1 kg/cm2,频率100次/min）组（C组）,每组15例.分别于开胸前（T0）,单肺通气后（A组于开胸后）30 min（T1）、90 min（T2）、150 min（T3）,手术结束时（T4）测定超氧化物歧化酶（SOD）活性及丙二醛（MDA）、一氧化氮（NO）浓度.结果 T2～T4时B、C组SOD活性[B组：（47±10）、（37±9）、（41±7）kU/L;C组：（58±12）、（51±11）、（49±9）kU/L]低于A组[（78±8）、（75±7）、（79±6）kU/L]（P＜0.05）,T1～T4时B、C组MDA、NO浓度高于A组（P＜0.05）;T3时C组SOD活性明显高于B组（P＜0.05）,T1～T4时C组MDA浓度及T2～T4时NO浓度低于B组（P＜0.05）.结论 HFJV能在一定程度上抑制单肺通气患者的氧化应激反应.

Objective To determine the effects of high-frequency jet ventilation （HFJV） on oxidative stress in patients during one-lung ventilation （OLV）. Methods Forty-five patients undergoing elective radical esophageal cancer resection were divided into three groups with 15 cases each by random digits table： two lung ventilation group （ group A）, OLV group （group B）, HFJV- OLV group （ group C, working pressure 1 kg/cm2 and frequency 100 times/min）. Venous blood samples were taken before induction （T0）,at30min （T1）,90min （T2）,150min （T3） after OLV and the end of operation （T4） for measuring serum superoxide dismutase（SOD）,malondialdehyde （MDA） and nitric oxide （NO）. Results SOD was lower at T2-T4 in group B[（47 ± 10）, （37 ±9）, （41 ±7） kU/L] and group C[（58 ± 12）, （51 ± 11）, （49 ± 9） kU/L] than those in group A [（78 ±8）, （75 ±7）, （79 ±6） kU/L]（P〈 0.05）,and MDA and NO were lower at T1-T4 in group B and group C than that in group A（P〈 0.05）. SOD was higher at T3 in group C than that in group B （P 〈 0.05）, MDA at T1-T4 and NO at T2-T4 were lower in group C than those in group B （P 〈 0.05）. Conclusion HFJV can effectively decrease oxidative stress in patients during OLV.