盐酸戊乙奎醚对老年肺癌患者根治术后肺部并发症的影响

Effect of penehyclidine hydrochloride on postoperative pulmonary complications in elderly patients undergoing radical resection of lung cancer

目的探讨盐酸戊乙奎醚对肺癌根治术老年患者术后肺部并发症的影响。方法选取择期拟行肺癌根治术的老年患者共80例,采用随机数字表法将患者分为两组,每组40例:盐酸戊乙奎醚组为实验组,患者于麻醉诱导前10 min静脉注射盐酸戊乙奎醚0.01 mg/kg,对照组静脉注射等容量生理盐水。分别于单肺通气即刻(T1)和单肺通气结束即刻(T2)时切取拟切除肺叶周边正常的肺组织,光镜下观察肺组织病理学的改变并进行肺损伤评分(IQA),电镜下观察肺组织超微结构的改变。记录两组术后72 h内肺部并发症发生率。计量资料组间比较采用t检验,组内比较采用重复测量方差分析。计数资料采用χ2检验。P<0.05为差异有统计学意义。结果与对照组比较,实验组患者T2时的肺组织IQA降低,肺组织损伤明显减轻。术后72 h内实验组肺部并发症总发生率为25.0%低于对照组的50.0%(P<0.05)。结论盐酸戊乙奎醚可减轻肺癌根治术老年患者非通气侧的肺损伤并降低术后肺部并发症发生率。

Objective To explore the effect of penehyclidine hydrochloride on postoperative pulmonary complications in elderly patients undergoing radical resection of lung cancer Methods A total of 80 elderly patients undergoing radical surgery of lung cancer, aged from 65 to 80, were randomly divided into two groups. Patients in experiment group （40 cases） were injected intravenously with penehyclidine hydrochloride at a dose of 0.01 mg/kg ten min before anesthesia induction. Patients in the control group were injected with the equal volume normal saline. The normal peripheral pulmonary tissue was removed at one lung ventilation immediately （T1） and immediately after the end of one lung ventilation （T2）. The pathological changes of lung tissue and lung injury score （IQA） were observed under light microscope. Ultrastructural changes of lung tissue were observed under electron microscope. The incidence of pulmonary complications in two groups after 72 h was recorded. Comparison of measurement data between groups using t test, intra group comparison using repeated measures analysis of variance and count data using Z2 test. P〈0.05 was considered statistically significant. Results Compared with the control group, the lung tissue IQA in the experimental group decreased and the lung tissue damage was obviously alleviated at T2. After 72 h, the total incidence of pulmonary complications in the experimental group（25%） was significantly lower than the control group （50%, all P〈0.05）. Conclusion Penehyclidine hydrochloride preconditioning can alleviate damage to non-ventilated lung and reduce the total incidence of postoperative pulmonary Complications in elderly patients undergoing radical surgery of lung cancer.