红景天注射液降低食管癌根治术患者单肺通气期间肺内分流及血清炎症介质:46例随机对照试验

Effects of Rhodiola rosea injection on intrapulmonary shunt and blood IL-6 and TNF-αlevels during single lung ventilation in patients undergoing radical resection ofesophageal cancer

目的探究红景天对食管癌根治术患者单肺通气期间肺内分流及血炎症介质的影响。方法选择行择期食管癌根治术患者46例,采取随机数字表法分为生理盐水对照组和红景天组(n=23)。红景天组于患者入室后将10mL红景天加入250mL生理盐水或5%葡萄糖注射液缓慢静脉滴注,对照组静滴同等剂量的生理盐水。抽取单肺通气(OLV)开始前(T_(0))、30min(T_(1))、60min(T_(2))、恢复双肺通气后30min(T3)的桡动脉和深静脉血各2mL,行血气分析,根据公式计算出肺内分流率(Qs/Qt)。分别记录各时间点PaO_(2)。于T_(0)、T_(1)、T3时抽取深静脉血2mL,检测血清中α-肿瘤坏死因子(TNF-α)、介素6(IL-6)含量,记录术后肺不张情况。结果与对照组相比,红景天组在T_(1)、T_(2)时,PaO_(2)、Qs/Qt优于对照组(P<0.05),红景天组在T3时IL-6、TNF-α含量降低(P<0.05)。两组患者术后肺不张发生率差异无统计学意义(P>0.05)。结论红景天可减少食管癌根治术患者单肺通气期间肺内分流,改善氧合,降低患者血清中IL-6、TNF-α含量,减轻患者术中肺损伤。

Objective To explore the effects of Rhodiola rosea injection on pulmonary shunt and serum interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels during single lung ventilation in patients undergoing radical resection of esophageal cancer.Methods Forty-six patients undergoing radical operation for esophageal cancer were randomized equally into control group and Rhodiola rosea injection group.In the Rhodiola group,10 mL of Rhodiola rosea injection was added into 250 mL of normal saline or 5%glucose solution for slow intravenous infusion,and normal saline of the same volume was used in the control group after the patients entered the operation room.At T_(0),T_(1)and T3,PaO_(2)of the patient was recorded and 2 mL of deep venous blood was collected for determination of serum TNF-αand IL-6 levels.The incidence of postoperative atelectasis of the patients was recorded.Results Compared with those in the control group,the patients receiving Rhodiola rosea injection had significantly higher PaO_(2)and Qs/Qt at T_(1)and T_(2)(P<0.05)and lower serum IL-6 and TNF-αlevels at T3(P<0.05).No significant difference in the incidence of postoperative atelectasis was observed between the two groups(P>0.05).Conclusion Rhodiola rosea injection before anesthesia induction can reduce intrapulmonary shunt during single lung ventilation,improve oxygenation,reduce serum IL-6 and TNF-αlevels,and alleviate intraoperative lung injury in patients undergoing radical resection of esophageal cancer.