保护性机械通气联合氟比洛芬酯对食管癌根治术患者肺的保护作用及对炎症因子、β-内腓肽和前列腺素水平的影响

Effect of protective mechanical ventilation combined with flurbiprofen axetil on the lung of patients undergoing radical esophagectomy and its effects on the levels of inflammatory factors, β-endofibrin and prostaglandin

目的探讨保护性机械通气联合氟比洛芬酯对食管癌根治术患者肺的保护作用及对患者炎症因子、β-内腓肽和前列腺素水平的影响。方法选取2018年1月至2018年12月在郑州大学第二附属医院行开胸食管癌根治术的120例患者为研究对象,分为对照组与观察组,每组60例。对照组给予保护性机械通气;观察组在对照组基础上联合氟比洛芬酯治疗。比较两组肺功能,肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、IL-8水平,及术后24 hβ-内腓肽(β-EP)、前列腺素(PGE)水平。结果观察组患者术后未出现肺功能异常,发生率明显低于对照组(11.67%,7/60,P<0.05)。术毕,观察组患者的TNF-α、IL-6、IL-8水平明显低于对照组(P<0.05);术后24 h,观察组患者的β-EP、PGE水平均明显低于对照组(P<0.05)。结论对行开胸食管癌根治术患者联合应用保护性机械通气与氟比洛芬酯可减轻患者炎症及应激反应,具有良好的肺保护作用。

Objective To investigate the protective effect of protective mechanical ventilation combined with flurbiprofen axetil on lung and the levels of inflammatory factors, beta-endorphin and prostaglandin in patients undergoing radical resection of esophageal cancer. Methods A total of 120 patients who underwent thoracotomy for esophageal cancer in the Second Affiliated Hospital of Zhengzhou University from January 2018 to December 2018 were selected as the study subjects.They were divided into control group and observation group, with 60 cases in each group.The control group received protective mechanical ventilation.The observation group was treated with flurbiprofen axetil on the basis of the control group.The lung function, levels of tumor necrosis factor(TNF)-alpha, interleukin(IL)-6 and IL-8, and levels of beta-endorphin(beta-EP) and prostaglandin(PGE) 24 hours after operation were compared between the two groups.Results The incidence of pulmonary dysfunction in the observation group was 0, significantly lower than that in the control group(11.67%, 7/60, P<0.05).After operation, the levels of TNF-a, IL-6 and IL-8 in the observation group were significantly lower than those in the control group(P<0.05).At 24 hours after operation, the levels of beta-EP and PGE in the observation group were significantly lower than those in the control group(P<0.05).Conclusions The combined application of protective mechanical ventilation and flurbiprofen axetil in patients undergoing thoracotomy for esophageal cancer can alleviate inflammation and stress response, and has good lung protection effect.