参附注射液对肺叶切除术患者单肺通气期间气道阻力和氧合功能的影响

Effect of shenfu injection on airway resistance and oxygenation during one-lung ventilation in patients un- dergoing Iobectomy

目的评价参附注射液对肺叶切除术患者单肺通气期间气道阻力和氧合功能的影响。方法择期胸段硬膜外阻滞复合全麻下行肺叶切除术患者60例，性别不限，年龄50～80岁，体重指数20～29kg／m2，ASA分级Ⅱ级，采用随机数字表法，将其随机分为2组（n=30）：生理盐水对照组（C组）和参附注射液组（S组）。麻醉诱导前，S组静脉输注参附注射液4．5ml·kg^-1·h^-120min；C组静脉输注等容量生理盐水。分别于单肺通气前、单肺通气30、60min及术毕时记录气道峰压，并采集动脉血样，测定Pan，计算氧合指数。结果与C组比较，S组单肺通气30、60min时气道峰压降低，氧合指数升高（P〈0．05）。结论参附注射液可降低肺叶切除术患者单肺通气期间气道阻力，提高氧合功能，提示其具有肺保护作用。

Objective To evaluate the effect of shenfu injection on airway resistance and oxygenation during one-lung ventilation （OLV） in patients undergoing lobectomy. Methods Sixty ASA Ⅱ patients of both sexes, aged 50-80, BMI 20-29 kg/m^2 , scheduled for lobectomy under thoracic epidural block combined with general anesthesia, were randomly divided into 2 groups（ n = 30 each） ：normal saline control group （group C） and shenfu injection group （group S）. In group S, shenfu injection was infused intravenously at 4.5 ml·kg^-1·h^-1for 20 min before anesthesia induction. In group C, equal volume of normal saline was infused instead of shenfu injection. Airway peak pressure was recorded and arterial blood samples were taken for determination of PaO2 before OLV, at 30,60 min of OLV and the end of surgery. Oxygenation index was calculated. Results Compared with group C, airway peak pressure was significantly decreased and oxygenation index increased at 30,60 rain of OLV in group S （ P 〈 0.05）. Conclusion Shenfu injection can decrease airway resistance and increase oxygenation during OLV in patients undergoing lobectomy, indicating that shenfu injection has a lung-protective effect.