参附注射液对肺叶切除病人肺氧合及通气功能的影响

EFFECT OF SHENFU INJECTION ON THE FUNCTION OF OXYGENATION AND VENTILATION OF LUNG IN PAIENTS AFTER LOBECTOMY

目的探讨参附注射液对肺癌肺叶切除病人术后肺氧合及通气功能的影响。方法肺癌肺叶切除病人62例,随机分为对照组(C组)和参附组(S组)。S组于麻醉前及术后24、48h将参附注射液1mL/kg体质量加生理盐水至250mL静脉输注,C组同速静脉输注等容量的生理盐水。分别于麻醉前(T0)及术后2h(T1)、6h(T2)、24h(T3)、48h(T4)、72h(T5)采集动脉血样,测定氧分压(PaO2)与二氧化碳分压(PaCO2),计算氧合指数;采用便携式肺功能仪于T0、T3、T4、T5时测量病人的用力肺活量(FVC)、第1秒用力肺活量(FEV1),计算FEV1/FVC比值。结果与C组比较,S组T1～T5时氧合指数升高,PaCO2降低(t=2.123～3.216,P<0.05);T3～T5时FVC、FEV1及FEV1/FVC比值升高(t=2.561～3.201,P<0.05);T0时两组上述指标比较差异无统计学意义(P>0.05)。结论参附注射液可明显改善肺叶切除病人术后肺氧合及通气功能,具有一定肺保护作用。

Objective To investigate the effect of Shenfu injection on post-lobectomy lung oxygenation and ventilation in patients underwent lobectomy for lung cancer. Methods Sixty-two patients received a lobectomy for lung cancer were equally randomized to Shengfu group and control group. In Shenfu group, the patients were given intravenous Shengfu injection-1 mL/kg diluted with normal saline to 250 mL-preanesthesia, and 24 and 48 hours postoperatively; to those in the control group, the same amount volume of normal saline was offered. The PaO2/FiO2, PaCO2 and oxygenation index were measured before anesthesia （T0）, and 2 h （T1）, 6 h （T2）, 24 h （T3）, 48 h （T4） and 72 h （T5） after surgery. A portable lung function device was used to detect FVC at To, T3, T4, T5, and the first second FEV1, the FEV1/FVC was then calculated. Results Compared with the control group, the oxygenation index at T1- Ts in the Shengfu group was elevated, and PaCO2 declined （t = 2. 123- 3.216, P 〈 0.05）; at T3--T5, FVC, FEV1 and FEV1/FVC heightened （t=2. 561-3. 201,P〈0.05）; at To, the differences of above para- meters between the two groups were not statistically significant （P〉0.05） Conclusion Shenfu injection can obviously improve the lung function of oxygenation and ventilation in patients received pulmonary lobectomy, possessing a certain protection of the lung.