七氟醚吸入麻醉对单肺通气下肺癌肺叶切除术围手术期肺功能及炎症反应的影响

Effects of Sevoflurane Inhalation Anesthesia on Perioperative Pulmonary Function and Inflammatory Response in Lung Cancer with Lobectomy under Single Lung Ventilation

目的探究七氟醚吸入麻醉对单肺通气下肺癌肺叶切除术围手术期肺功能及炎症反应的影响。方法方便选取2016年1—6月该院收治的160例肺癌肺叶切除术围手术期患者,随机将其分为对照组和观察组,各80例。对照组术前予以丙泊酚静脉泵注,观察组则予七氟醚吸入麻醉。检测两组患者各时间点的相关生化指标及生理指标。结果两组患者T0、T1时刻血清炎症因子水平比较差异无统计学意义(P>0.05),而在T3时刻,观察组血清IL-8、IL-10及TNF-α的水平(23.01±9.21)nmol/L,(21.43±8.74)U/mL,(19.36±5.83)ng/L皆明显低于对照组(27.18±9.05)nmol/L,(27.64±7.42)U/mL,(30.60±9.47)ng/L,差异有统计学意义(t=2.89、6.08、8.61,P<0.05)。两组患者T1、T2时刻MAP、HR及SpO2比较差异无统计学意义(P>0.05),而在T3时刻,观察组MAP、HR的指标(76.46±4.29)p/mmHg,(70.21±4.22)次/min皆明显低于对照组(79.53±4.51)p/mmHg,(74.63±3.86)次/min,差异有统计学意义(t=4.53、3.22,P<0.05),SpO2(94.37±4.02)%则高于对照组(92.06±3.25)%,差异有统计学意义(t=4.00,P<0.05)。结论七氟醚吸入麻醉对拟行单肺通气下肺癌肺叶切除术围手术期患者麻醉效果确切,患者肺功能预后良好,并能有效减轻组织炎症损伤,值得临床推广。

Objective To investigate the effects of sevoflurane inhalation anesthesia on perioperative lung function and inflammatory response in lung cancer with lobectomy under single lung ventilation.Methods A total of 160 patients with perioperative lung cancer lobectomy were convenient selected and enrolled in the hospital from January to June 2016.They were randomly divided into control group and observation group,80 cases each.The control group received propofol intravenous pumping before surgery and the sevoflurane inhalation anesthesia in the observation group.The relevant biochemical indicators and physiological indexes at each time point of the two groups of patients were detected.Results There was no significant difference in serum inflammatory factors between T0 and T1 in the two groups (P>0.05).At the time of T3,the levels of serum IL-8,IL-10 and TNF-α in the observation group (23.01±9.21)nmol/L,(21.43±8.74)U/mL,(19.36±5.83)ng/L were significantly lower than the control group (27.18±9.05)nmol/L,(27.64±7.42)U/mL,(30.60±9.47)ng/L,the different was statistically significant(t=2.89,6.08,8.61,P<0.05).There were no significant differences in MAP,HR and SpO2 between the two groups at T1 and T2(P>0.05).At T3,the MAP and HR indicators (76.46±4.29)p/mmHg,(70.21±4.22)times/min were significantly lower than those in the observation group.The control group (79.53±4.51)p/mmHg,(74.63±3.86)times/min (t=4.53,3.22,P<0.05),and the SpO2 (94.37±4.02)% was higher than the control group (92.06±3.25)%,the different was statistically significant(t=4.00,P<0.05).Conclusion Inhalation anesthesia with sevoflurane is effective in the perioperative period of lung cancer with lobectomy for single lung ventilation.The prognosis of lung function is good,and it can effectively alleviate tissue inflammatory injury.It is worthy of clinical promotion.