依达拉奉对单肺通气老年患者肺功能的影响

Effects of Edaravone on Pulmonary Function during One-lung Ventilation in Elderly Patients

目的探讨依达拉奉对单肺通气老年患者肺功能的影响。方法择期拟行食管癌根治术患者40例,年龄60～75岁,体重指数(BMI)18～26 kg/m2,ASA分级Ⅰ或Ⅱ级,随机分为对照组(C组,n=20)和依达拉奉组(E组,n=20)。E组于入室后即刻,以60 mg/h速率静脉输注依达拉奉30 min,随后以7.5 mg/h的速率输注至术毕,C组采用同样方法静脉输注等容量生理盐水。分别于单肺通气前(T0)、单肺通气60 min(T1)、恢复双肺通气30 min(T2)记录CVP、HR、MAP和气道平均压(Pmean),同时采集桡动脉血样和颈内静脉血样进行血气分析,计算呼吸指数(RI)。结果两组T0时Pmean、PaO2和RI比较差异无统计学意义(P>0.05);与T0时比较,两组T1时和T2时Pmean和RI升高,PaO2降低(P<0.05);与C组比较,E组T1、T2时RI、Pmean降低和PaO2升高(P<0.05)。结论静脉输注依达拉奉可减轻单肺通气对老年患者肺功能的损害,具有肺保护作用。

Objective To investigate the effects of edaravone on the lung function during one lung ventilation in elder pa-tients. Methods Forty ASA I or N patients undergoing elective esophageal cancer resection, aged 60-75 years, BMI 18 - 26 kg/m^2 ,were randomly divided into 2 groups（ n = 20 each） ： control group（ group C） and edaravone group（ group E）. In the group E, edaravone was infused before anesthesia at 60.0 mg/h for 30 rain. Then the infusion rate was reduced to 7.5 mg/h and main-tained until the end of operation. In the group C, equal volume of normal saline was infused instead of edaravone. MAP, HR, CVP, mean airway pressure were monitored and recorded at before OLV （T0 ）, at 60 min of OLV（ T1 ） and 30 min after re-expansion of the collapsed lung（ T2 ）. Blood samples were taken simultaneously from jugular vein and radial artery for blood gas analysis and respiratory index（RI） （ RI = PA-sO2/PaO2 ） were calculated. Results There was no significant difference in mean airway pres-sure, PaO2 and RI before one lung ventilation between the two groups （ T0 ）. Compared with To, the values of PaO2 were lower and mean airway pressure and RI were significantly increased in the two groups at T1-2 （ P 〈 0.05 ）. The values of PaO2 in group E is higher and mean airway pressure and RI is lower than thaf in group C at T1-2 （ P 〈 0.05 ）. Condusion Edaravone can reduce the lung injury during one lung ventilation and provide better lung protection in elder patients.