七氟烷预处理对单肺通气肺叶切除患者肺功能指标的影响分析

Effect of Sevoflurane Preconditioning on Pulmonary Function in Patients Undergoing Pulmonary Lobectomy with Single Lung Ventilation

研究七氟烷预处理对单肺通气肺叶切除患者肺功能指标的影响。选取2016年1月~2017年10月在该院择期行肺叶切除的患者100例为研究对象,将其以随机数字表法均分成研究组和对照组。对照组在行单肺通气后予以七氟烷吸入处理,研究组则在行单肺通气前30 min予以七氟烷吸入处理。分别比较两组患者不同时间点的肺功能指标、应激反应相关指标、炎症反应指标水平的变化情况,并对比两组患者术后不良反应发生情况。不同时间点两组患者Pa O2与Pa CO2水平对比均不明显,组间对比差异无统计学意义(均P>0.05)。T1时两组血清SOD、MDA水平对比不明显,组间对比差异无统计学意义(均P>0.05);T2与T3时研究组血清SOD、MDA水平均明显低于对照组,组间对比差异有统计学意义(均P<0.05)。T1时两组血清IL-8与TNF-α水平对比不明显,组间对比差异无统计学意义(均P>0.05);T2与T3时研究组患者血清IL-8与TNF-α水平均明显低于对照组,组间对比差异有统计学意义(均P<0.05)。研究组与对照组肺部感染、肺不张以及呼吸困难的发生率对比均不明显,组间对比差异均无统计学意义(均P>0.05)。七氟烷预处理对单肺通气肺叶切除患者肺功能指标影响较轻微,但有效减轻应激反应程度与炎症反应程度,具有较好的安全性,临床推广应用价值较高。

To study the effect of sevoflurane preconditioning on pulmonary function in patients with single lung ventilation lobectomy,100 patients with pulmonary lobectomy enrolled into the People＇ s Hospital of Lanling between January 2016 and March 2017 were randomly and equally divided into study group and control group respectively. The control group received sevoflurane inhalation after single lung ventilation,while the study group received sevoflurane inhalation 30 minutes before single lung ventilation. The pulmonary function indexes as indicated as Pa O2 and Pa CO2 values were compared between the two groups at different time points. The changes of stress response related index,inflammatory response index,and the occurrence of adverse responses after operation were compared between the two groups. There was no significant difference between Pa O2 and Pa CO2 in the two groups at different time points（ P〉 0. 05）. At T1,the levels of SOD and MDA in the two groups had no significant difference（ P〉 0. 05）,while the serum SOD and MDA levels in research group were significantly lower than the control group at T2 and T3（ P〈 0. 05）. At T1,the levels of IL-8 and TNF-α in the two groups had no statistically significant difference between the two groups（ P〉 0. 05）,while at T2 and T3,the levels of serum IL-8 and TNF-α were significantly lower in the research group than that of the control group（ P〈 0. 05）. Moreover,there was no significant difference in the incidence of pulmonary infection,atelectasis,and breathing difficulties between research group and the control group（ P〉 0. 05）. Sevoflurane pretreatment can effectively reduce the degree of stress response and inflammatory response without resulting apparent adverse effect on lung function index,pulmonary infection,atelectasis,and breathing difficulties in patients with single-lung ventilation and pulmonary lobectomy,suggesting that this procedure has good safety and high clinical application value.