肺保护性通气对胸腔镜肺癌根治术患者细胞免疫功能及肺静态顺应性的影响

Effects of Lung Protective Ventilation on Cellular Immune Function and Pulmonary Static Compliance in Patients Undergoing Thoracoscopic Radical Resection of Lung Cancer

目的:探讨肺保护性通气应用于胸腔镜肺癌根治术患者对其细胞免疫功能及肺静态顺应性的影响。方法:选取某院2019年6月-2021年6月125例行胸腔镜肺癌根治术患者分为对照组62例和观察组63例,两组患者均行相同的术前准备,术后进行相同的镇痛处理措施。对照组采用常规通气策略,观察组采用肺保护性通气策略,对比两组患者细胞免疫功能与肺静态顺应性。结果:观察组治疗后血清中外周血T淋巴细胞亚群CD3^(+)、CD4^(+)、CD8^(+)、NK细胞数量、CD4^(+)/CD8^(+)水平分别为(49.34±5.12)%、(39.61±1.26)%、(39.69±3.89)%、(22.12±2.56)个、(1.12±0.11),均高于对照组的(42.36±4.45)%、(32.89±1.02)%、(35.35±2.15)%、(16.26±2.12)个、(0.96±0.09)(P<0.05);观察组T1~T4时的Cs值分别为(40.45±2.23)mL/cmH_(2)O、(31.23±3.12)mL/cmH_(2)O、(32.33±1.91)mL/cmH_(2)O、(44.45±2.05)mL/cmH_(2)O,均高于对照组的(30.36±1.25)mL/cmH_(2)O、(26.12±2.14)mL/cmH_(2)O、(24.45±1.46)mL/cmH_(2)O、(38.36±1.88)mL/cmH_(2)O(P<0.05)。结论:肺保护性通气应用于胸腔镜肺癌根治术患者,能有效改善患者细胞免疫功能,提高肺静态顺应性,值得临床使用。

Objective:To investigate the effect of lung protective ventilation on cellular immune function and pulmonary static compliance in patients undergoing thoracoscopic radical resection of lung cancer.Methods:A total of 125 patients who underwent thoracoscopic radical resection of lung cancer in a hospital from June 2019 to June 2021 were selected and divided into two groups.Both groups underwent the same preoperative preparation and the same analgesic treatment measures after surgery.62 patients in the control group were given conventional ventilation strategy,and 63 patients in the observation group were given lung-protective ventilation strategy.The cellular immune function and pulmonary static compliance were compared between the two groups.Results:After treatment,the peripheral blood T lymphocyte subsets CD3^(+),CD4^(+),CD8^(+),NK cells counts,and CD4^(+)/CD8^(+) levels in the observation group were(49.34±5.12)%,(39.61±1.26)%,(39.69±3.89)%,(22.12±2.56),and(1.12±0.11),respectively,all higher than those in the control group[(42.36±4.45)%,(32.89±1.02)%,(35.35±2.15)%,(16.26±2.12),(0.96±0.09)],and the difference was statistically significant(P<0.05);The Cs values of the observation group at T1-4 were(40.45±2.23)mL/cmH_(2)O,(31.23±3.12)mL/cmH_(2)O,(32.33±1.91)mL/cmH_(2)O,and(44.45±2.05)mL/cmH_(2)O,respectively,all higher than those of the control group[(30.36±1.25)mL/cmH_(2)O,(26.12±2.14)mL/cmH_(2)O,(24.45±1.46)mL/cmH_(2)O,(38.36±1.88)mL/cmH_(2)O],and the difference was statistically significant(P<0.05).Conclusion:The application of lung protective ventilation in patients with thoracoscopic radical resection of lung cancer can effectively improve the cellular immune function of patients and improve the pulmonary static compliance,which is worthy of clinical application.