丙泊酚与七氟醚对单肺通气下肺癌肺叶切除术患者围术期肺功能的影响比较

Comparison of effect of propofol and sevoflurane on perioperative lung function of patients undergoing lung cancer lobectomy under one-lung ventilation

目的比较丙泊酚与七氟醚对单肺通气下肺癌肺叶切除术患者围术期肺功能的影响。方法选取我院收治的86例行单肺通气下肺癌肺叶切除术患者,将其随机分成七氟醚组(43例,采用七氟醚维持麻醉)和丙泊酚组(43例,采用丙泊酚维持麻醉)。比较两组患者各时间点的血流动力学指标、肺功能指标及MDA、MMP-9水平。结果两组患者各时间点的CO、CVP、MAP、HR比较,差异均无统计学意义(P>0.05)。T1、T2、T3时,丙泊酚组的Qs/Qt低于七氟醚组(P<0.05);T2、T3时,丙泊酚组的RI低于七氟醚组(P<0.05);T3时,丙泊酚组的A-aDO2低于七氟醚组(P<0.05)。T3时,丙泊酚组的MDA、MMP-9水平均低于七氟醚组(P<0.05)。结论丙泊酚麻醉对单肺通气下肺癌肺叶切除术患者肺功能的损伤程度小于七氟醚麻醉,且过氧化程度、炎性反应较轻。

Objective To compare the effect of sevoflurane and propofol on perioperative lung function of patients undergoing lung cancer lobectomy under one-lung ventilation.Methods A total of 86 patients admitted in our hospital who underwent lung cancer lobectomy under one-lung ventilation were selected and randomly divided into sevoflurane group(43 cases,treated with sevoflurane for maintenance anesthesia)and propofol group(43 cases,treated with propofol for maintenance anesthesia).The hemodynamic indexes,lung function indexes,MDA and MMP-9 levels of the two groups were compared at each time point.Results There were no significant differences in CO,CVP,MAP and HR between the two groups at each time point(P>0.05).At T1,T2,and T3,the Qs/Qt of the propofol group were lower than that of the sevoflurane group(P<0.05);at T2,T3,the RI of the propofol group were lower than that of the sevoflurane group(P<0.05);at T3,the A-aDO2 of the propofol group was lower than that of the sevoflurane group(P<0.05).At T3,the levels of MDA and MMP-9 of the propofol group were lower than those of the sevoflurane group(P<0.05).Conclusion Propofol anesthesia for patients undergoing lung cancer lobectomy under one-lung ventilation cause less lung function damage compared with sevoflurane anesthesia,and has milder the peroxidation degree and inflammatory reaction.