单肺通气肺癌根治术前适应性间断通气对非通气侧肺组织损伤及凋亡分子蛋白表达的影响

Effect of adaptive intermittent ventilation before radical operation for lung cancer under onelung ventilation on the non-ventilated lung tissue injury and apoptosis molecule protein expression

目的:探讨单肺通气肺癌根治术前适应性间断通气对非通气侧肺组织损伤及凋亡分子蛋白表达的影响。方法:选取在本院接受肺癌根治术的患者288例,经随机数表法将入组患者分为对照组、观察组各144例。对照组接受常规单肺通气,观察组接受非通气侧肺组织术前适应性间断通气。对比两组插管后即刻、双肺通气时(T0)、手术结束前10min、单肺通气时(T1)血清炎症因子、氧化应激指标含量以及患侧正常肺组织凋亡分子蛋白表达量的差异。结果:T0时,两组血清中炎症因子、氧化应激指标含量以及患侧正常肺组织凋亡分子蛋白表达量的差异无统计学意义;T1时,观察组血清中IL-1β、IL-8、TNF-α、MPO、MDA的含量以及正常肺组织中Bax、caspase-2、caspase-3的蛋白表达量较对照组患者低,血清中SOD的含量以及正常肺组织中Bcl-2的蛋白表达量较对照组患者高。结论:单肺通气肺癌根治术前适应性间断通气可有效减少非通气侧肺组织损伤,抑制正常肺细胞的凋亡。

Objective:To study the effect of the adaptive intermittent ventilation before radical operation for lung cancer under one lung ventilation on non ventilated lung tissue injury and apoptosis molecule protein expression.Methods:288patients who received radical operation for lung cancer in the hospital between February2015and January2017were divided into control group and observation group by random number table method,each with144cases.Control group received routine one lung ventilation,and observation group received preoperative adaptive intermittent ventilation of non ventilated lung tissue.The differences in the levels of inflammatory factors and oxidative stress indexes in serum as well as the apoptosis molecule protein expression in affected side normal lung tissue were compared between the two groups of patients immediately after intubation and at two lung ventilation(T0)as well as10min before operation ended and at one lung ventilation(T1).Results:At T0,the differences in the levels of inflammatory factors and oxidative stress indexes in serum as well as the apoptosis molecule protein expression in affected side normal lung tissue were not significantly significant between the two groups of patients;at T1,IL1β,IL8,TNFα,MPO and MDA levels in serum as well as Bax,caspase2and caspase3protein expression in normal lung tissue of observation group were lower than those of control group while SOD level in serum and Bcl2protein expression in normal lung tissue were higher than those of control group.Conclusion:Adaptive intermittent ventilation before radical operation for lung cancer under one lung ventilation can effectively reduce the non ventilated lung tissue injury and inhibit the apoptosis of normal lung cells.