摘要
目的研究分析肺保护通气模式+右美托咪定对胸腔镜下肺癌根治术肺功能的保护作用。方法随机选择2018年1月—2021年8月在阜宁县人民医院行胸腔镜下肺癌根治术的肺癌患者70例,依据抛硬币法将患者分为参照组与研究组,各35例。参照组单纯采用肺保护通气模式,研究组采用肺保护通气模式+右美托咪定,对两组手术相关指标以及麻醉诱导即刻(T0)、单肺通气30 min(T1)、单肺通气60 min(T2)、术毕(T3)的肺功能指标、炎症因子指标进行观察比较。结果两组手术时间、术中出血量、单肺通气时间、输胶体量、输晶体量比较,差异无统计学意义(P>0.05)。与T0比较,两组T1、T2时呼吸指数(RI)、氧合指数(OI)、动脉肺泡氧分压比(PaO2/PAO2)均有明显变化,差异有统计学意义(P<0.05);研究组T1、T2时RI、OI、PaO2/PAO2分别为(0.60±0.14)、(0.86±0.20)、(310.25±50.58)、(221.25±42.38)、(0.60±0.06)、(0.55±0.04),均明显优于参照组,差异有统计学意义(P<0.05)。与T0比较,两组T1、T2、T3时IL-6、IL-8、TNF-α水平均明显升高,差异有统计学意义(P<0.05);研究组T1、T2、T3时IL-6、IL-8、TNF-α水平均明显低于参照组,差异有统计学意义(P<0.05)。结论肺保护通气模式+右美托咪定对胸腔镜下肺癌根治术肺功能的保护作用十分确切,有助于改善患者肺功能,减轻炎症反应,值得临床借鉴应用。
Objective To study and analyze the protective effect of lung-protective ventilation mode+dexmedetomidine on lung function after thoracoscopic radical resection of lung cancer.Methods A total of 70 patients with lung cancer who underwent thoracoscopic radical resection of lung cancer in Funing County People’s Hospital from January 2018 to August 2021 were randomly selected,and the patients were divided into the reference group and the study group according to the coin toss method,with 35 cases each.The reference group was only in lung protection ventilation mode,while the study group was in lung protection ventilation mode+dexmedetomidine.The operation-related indexes,pulmonary function indexes and inflammatory factor indexes at the time of anesthesia induction(T0),onelung ventilation for 30 min(T1),one-lung ventilation for 60 min(T2),and after surgery(T3)were observed and compared between the two groups.Results There was no statistically significant difference in operation time,intraoperative blood loss,one-lung ventilation time,colloid volume and crystalloid volume between the two groups(P>0.05).Compared with T0,the respiration index(RI),oxygenation index(OI),and arterial alveolar oxygen partial pressure ratio(PaO2/PAO2)were significantly changed at T1 and T2 in the two groups,and the difference was statistically significant(P<0.05).The RI,OI,PaO2/PAO2of the study group at T1 and T2 were(0.60±0.14),(0.86±0.20),(310.25±50.58),(221.25±42.38),(0.60±0.06),(0.55±0.04),respectively,were significantly better than the reference group,and the difference was statistically significant(P<0.05).Compared with T0,the levels of IL-6,IL-8,and TNF-αwere significantly increased at T1,T2,and T3 in the two groups,and the difference was statistically significant(P<0.05).The levels of IL-6,IL-8 and TNF-αin the study group at T1,T2 and T3 were significantly lower than those in the reference group,and the difference was statistically significant(P<0.05).Conclusion The protective effect of lung-protective ventilation mode+dexmedetomidine on pulmonary function after thoracoscopic radical resection of lung cancer is very precise,and it is helpful to improve the lung function and reduce the inflammatory response,which is worthy of clinical application.
作者
张鹏
石金鑫
朱烨
ZHANG Peng;SHI Jinxin;ZHU Ye(Department of Anesthesiology,Funing County People´s Hospital,Yancheng,Jiangsu Province,224400 China)
出处
《中外医疗》
2022年第28期79-82,87,共5页
China & Foreign Medical Treatment
基金
盐城市医学科技发展计划项目(YK2020090)。
关键词
肺癌
肺保护通气模式
右美托咪定
肺功能
炎症因子
Lung cancer
Lung protective ventilation mode
Dexmedetomidine
Lung function
Inflammatory factors
作者简介
张鹏(1976-),男,本科,副主任医师,研究方向为麻醉方面;通信作者:石金鑫(1966-),男,本科,副主任医师,研究方向为疼痛方面,E-mail:yunbao201202@163.com。
