丙泊酚和异氟醚对支气管粘液运输速度的影响

Effect of propofol or isoflurane on bronchial mucus transport velocity in human

目的 观察丙泊酚静脉麻醉和异氟醚吸入麻醉对人支气管粘液运输速度的影响。方法 选择 4 0例ASAⅠ～Ⅱ级病人 ,随机分两组 ,每组 2 0例。异氟醚组吸入 2MAC异氟醚 ,丙泊酚组静脉丙泊酚麻醉 ,两组病人分别在机械通气 1 0和 6 0min后 ,测量支气管粘液运输速度。方法是在小儿支气管镜直视下 ,在左主支气管背部粘膜上方注射亚甲蓝 ,标记染料在 0、2、4、6min的移动距离 ,计算支气管粘液运输速度。结果 异氟醚组机械通气 1 0和 6 0min后的测量值分别为 (1 4 1 0±1 4 5 )mm/min和 (1 0 1 0± 2 0 0 )mm/min ,通气 6 0min较 1 0min粘液运输速度显著下降 (P <0 0 5 ) ;丙泊酚组 1 0和 6 0min的测量值分别为 (1 4 1 0± 1 6 3)mm/min和 (1 4 70± 1 4 6 )mm/min ,通气 6 0min较 1 0min粘液运输速度上升 ,但无统计学差异 (P >0 0 5 )。两组在机械通气 1 0min后 ,差异不显著 (P >0 0 5 ) ;在 6 0min后 ,分别为 (1 4 70± 1 4 6 )mm/min和 (1 0 1 0± 2 0 0 )mm/min ,丙泊酚组运输速度显著高于异氟醚 (P <0 0 5 )。结论 异氟醚抑制支气管粘液的运输速度 ;丙泊酚静脉麻醉加快粘液运输速度 。

Objective To investigate the influence of isoflurane inhalation and intravenous propofol on bronchial mucus transport velocity(BTV) in human.Methods Forty ASAⅠ Ⅱ patients were selected and divided into two groups at random.One group inhaled 2MAC isoflurane and the another was given propofol maintaining anesthesia.BTV was measured at 10 and 60min after mechanical ventilation using fiberoptic bronchoscope to observe the movement of methylene blue injected onto the dorsal surface of the left main bronchus.Results BTV in the isoflurane group was significantly slower at 60min(10 10±2 00)mm/min than that at 10min(14 10±1 45)mm/min( P< 0 05).BTV in the propofol group was faster at 60min(14 70±1 46)mm/min than that at 10min(14 10±1 63)mm/min( P> 0 05).BTV of two groups was similar at 10min(14 10±1 45)mm/min and (14 10±1 63)mm/min respectively( P> 0 05),but was significantly faster in the propofol group than that in the isoflurane group at 60min为(14 70±1 46)mm/min and (10 10±2 00)mm/min respectively( P< 0 05).Conclusions Inhaling isoflurane can inhibit BTV.Intravenous propofol can increase BTV and protect the function of the airway mucosa. [