摘要
目的探讨盐酸戊乙奎醚对胸腔镜下肺叶切除术单肺通气患者呼吸力学、动脉血气及炎症因子的影响。方法采取随机对照研究,选取2022年1-11月金华市中心医院行胸腔镜下肺叶切除术单肺通气患者100例,按照随机数字表法分为A组、B组各50例。A组术前30 min静脉滴注盐酸戊乙奎醚0.02 mg/kg,B组术前30 min静脉滴注等量0.9%氯化钠注射液。比较组临床指标、呼吸力学指标[气道峰压(Ppeak)、肺顺应性(CL)]、动脉血气分析指标[血氧饱和度(SpO_(2))、血氧分压(PaO_(2))、氧合指数(OI)]、炎症因子水平[白细胞介素6(IL-6)、IL-8、肿瘤坏死因子α(TNF-α)]、肺部并发症。结果两组机械通气时间、输液总量差异均无统计学意义(均P>0.05)。A组术毕时(T1)、术后1 d(T2)的Ppeak[(17.43±2.69)cmH_(2)O、(16.81±2.28)cmH_(2)O](1 cmH_(2)O=0.098 kPa)均低于B组[(19.23±3.40)cmH_(2)O、(18.29±2.06)cmH_(2)O](t=2.94、3.41,P=0.002、<0.001);A组T1、T2的CL[(34.67±2.93)cmH_(2)O、(36.26±3.11)cmH_(2)O)]均高于B组[(32.23±2.85)cmH_(2)O、(33.84±2.87)cmH_(2)O)](t=4.22、4.04,P=0.000、<0.001)。A组T1、T2的SpO_(2)、PaO_(2)、OI均高于B组(t=8.12、3.07、10.47、3.16、3.81、4.15,均P<0.05)。A组T1、T2的IL-6、IL-8、TNF-α均低于B组(t=11.67、13.55、9.60、15.71、6.13、11.50,均P<0.001)。A组并发症发生率为4%(2/50),低于B组的16%(8/50)(χ^(2)=4.00,P<0.05)。结论盐酸戊乙奎醚对胸腔镜下肺叶切除术单肺通气患者呼吸力学、动脉血气及炎症因子有较好的改善作用,值得推广。
Objective To investigate the effect of penehyclidine hydrochloride on respiratory mechanics,arterial blood gas,and inflammatory factors in patients undergoing one-lung ventilation during thoracoscopic lobectomy.Methods A total of 100 patients who underwent thoracoscopic lobectomy with one-lung ventilation at Jinhua Central Hospital from January to November 2022 were included in this randomized controlled study.They were divided into groups A and B(n=50 per group)using a random digital number table.Patients in group A received an intravenous infusion of 0.02 mg/kg of pentylenethyclidine hydrochloride 30 minutes before surgery,while patients in group B received an equal amount of 0.9%sodium chloride injection 30 minutes before surgery.Clinical indicators,respiratory mechanical indicators(peak airway pressure,lung compliance),arterial blood gas analysis indicators(blood oxygen saturation,arterial pressure of oxygen,oxygenation index),inflammatory factor levels(interleukin-6,interleukin-8,tumor necrosis factor level-α),and pulmonary complications were compared between the two groups.Results There were no significant differences in mechanical ventilation time or total infusion volume between the two groups(both P>0.05).At the end of surgery(T1)and 1 day after surgery(T2),peak airway pressure in group A was(17.43±2.69)cm H_(2)O and(16.81±2.28)cm H_(2)O(1 cm H_(2)O=0.098 kPa),respectively,which were significantly lower than(19.23±3.40)cm H_(2)O and(18.29±2.06)cm H_(2)O in group B,respectively(t=2.94,3.41,P=0.002,<0.001).At T1 and T2,lung compliance in group A was(34.67±2.93)cm H_(2)O and(36.26±3.11)cm H_(2)O,respectively,which were significantly higher than(32.23±2.85)cm H_(2)O and(33.84±2.87)cm H_(2)O in group B,respectively(t=4.22,4.04,P=0.000,<0.001).At T1 and T2,blood oxygen saturation,arterial partial pressure of oxygen,and oxygenation index in group A were significantly higher than those in group B(t=8.12,3.07,10.47,3.16,3.81,4.15,all P<0.05).At T1 and T2,interleukin-6,interleukin-8,and tumor necrosis factor-αlevels in group A were significantly lower than those in group B(t=11.67,13.55,9.60,15.71,6.13,11.50,all P<0.001).The incidence of complications in group A was 4%(2/50),which was significantly lower than 16%(8/50)in group B(χ^(2)=4.00,P<0.05).Conclusion Penehyclidine hydrochloride has a good effect on respiratory mechanics,arterial blood gas,and inflammatory factors in patients undergoing thoracoscopic lobectomy with one-lung ventilation and thereby deserves clinical promotion.
作者
朱忠权
柴华
赵栋
王立萍
Zhu Zhongquan;Chai Hua;Zhao Dong;Wang Liping(Department of Anesthesiology,Jinhua Hospital Affiliated to Zhejiang University School of Medicine(Jinhua Central Hospital),Jinhua 321000,Zhejiang Province,China)
出处
《中国基层医药》
CAS
2023年第12期1798-1803,共6页
Chinese Journal of Primary Medicine and Pharmacy
基金
浙江省公益技术应用研究资助项目(LGF19H010008)。
关键词
肺切除术
胸腔镜检查
呼吸力学
血气分析
白细胞介素6
白细胞介素8
肿瘤坏死因子α
单肺通气
盐酸戊乙奎醚
Pneumonectomy
Thoracoscopy
Respiratory mechanics
Blood gas analysis
Interleukin-6
Interleukin-8
Tumor necrosis factor-alpha
One-lung ventilation
Pentylenethyclidine hydrochloride
作者简介
通信作者:柴华,Email:330404646@qq.com。
