摘要
目的探讨远隔缺血预处理(RIPC)对全身麻醉下开胸手术患者单肺通气(OLV)时肺损伤的影响。方法择期行开胸食管癌根治术患者80例,采用随机数字表法分为2组(n=40):对照组(C组)和肢体RIPC组(RIPC组)。于OLV即刻(T1)、30min(T2)、1h(T3)、2h(T4)时采集桡动脉血样行血气分析,计算氧合指数(OI)、呼吸指数(RI)和PaO2/PAO2,采用酶联免疫吸附法测定血浆TNF-α、IL-1β和IL-10的水平,收集呼出气冷凝液,测定pH值。结果与C组比较,RIPC组T2~T4时OI升高,RI降低,PaO2/PAO2升高,T3~T4时,血浆TNF-α和IL-1β水平降低,呼出气冷凝液pH值升高,T4时血浆IL-10水平升高(P<0.05)。结论 RIPC可抑制开胸手术患者OLV时的炎性反应,减轻气道酸化,从而减轻肺损伤。
Objective To investigate the effect of remote ischemic preconditioning(RIPC)on the lung injury during one-lung ventilation(OLV)in the patients undergoing thoracic surgery.Methods Eighty patients scheduled for elective radical operation for esophageal cancer,were randomly divided into 2groups(n=40each)using a random number table:control group(group C)and group RIPC.At 0(T1),30min(T2),1h(T3)and 2h(T4)of OLV,blood samples were obtained from the radial artery for blood gas analysis and determination of plasma concentrations of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and IL-10.Oxygenation index(OI),respiratory index(RI)and PaO2/PAO2 were calculated.Exhaled breath condensate was collected and the pH value was measured.Results Compared with group C,Oxygenation index was significantly increased,and respiratory index was decreased at T2-T4,the plasma concentrations of TNF-αand IL-1βwere decreased,and the pH value of exhaled breath condensate was increased at T3-T4,and the plasma concentration of IL-10 was increased at T4 in group RIPC.Conclusion RIPC can inhibit inflammatory responses and reduce airway acidification,thus attenuating the lung injury during OLV in the patients undergoing thoracic surgery.
出处
《重庆医学》
CAS
北大核心
2017年第6期764-766,769,共4页
Chongqing medicine
基金
河南省医学科技攻关项目(201503037)
河南省重点科技攻关项目(132102310103)
河南省教育厅科技攻关项目(13B320389)
关键词
四肢
缺血预处理
肺通气
急性肺损伤
肺保护
extremities
ischemic preconditioning
pulmonary ventilation
acute lung injury
lung protection