雾化吸入伊洛前列环素在开胸手术中的应用研究

The clinical applications and significance of nebulized iloprost on open-chest surgery

目的观察评价雾化吸入伊洛前列环素在开胸手术中应用的临床效果。方法选择单侧肺叶切除术患者60例。随机分为常规给药组和对照组。每组各30例。给药组单肺通气后雾化吸入20μg伊洛前列环素15分钟,在气管插管后(T1)、停吸15分钟(T2)、停吸30分钟(T3)分别采集两组静脉血3mL,检测白细胞介素-6(IL-6)、白细胞介素-8(IL-8)的含量及血气分析。结果对照组IL-6、IL-8浓度在T2、T3时点高于给药组,差异有显著性(P<0.05)。对照组氧合指数(OI)值在T2时点、T3时点较给药组降低,差异有显著性(P<0.05)。结论开胸手术在单肺通气后雾化吸入20μg伊洛前列环素显著减少单肺通气期间及术后早期炎性因子释放,减轻术后肺水肿,从而起到肺保护的作用。

Objective To study the clinical significance of nebulized iloprost used in thoracotomy surgery.Methods Sixty patients underwent unilateral lobectomy resection were selected to randomly divided into the drug group（n=30） and the control group（n=30） after one-lung ventilation,20μg iloprost were nebulized and inhaled to ventilation circuit.Blood samples of 3 ml were extracted at three time courses,which were after tracheal intubation（T1）,15min ang 30min after stoping nebulizeing（T2 T3） to analye concentrations of interleukin（IL-6,IL-8） and Blood gas analysis in the two groups.Results Concentrations of IL-6、IL-8 at T2、T3 were significantly higher in control group than in drug group,which the difference has statistics meaning（P〈0.05）.In control group,values of OI at T2、T3 were significantly reduced as compared with those of drugt group（P〈0.05）.Conclusions After one-lung ventilation,nebulized iloprost can decrease the release of IL-6、IL-8 during OLV and postoperatively,and inhibit early post-operational pneumonia reaction to protect lung function.