盐酸戊乙奎醚在合并COPD患者腹部手术中对肺功能的保护作用的临床研究

目的探讨盐酸戊乙奎醚能否改善合并COPD患者腹部手术中肺功能。方法 60例合并COPD行腹部手术患者随机分为两组,治疗组(n=30)和对照组(n=30)。治疗组麻醉前10min静脉注射长托宁0.03mg/kg;对照组术前30min肌肉注射东莨菪碱0.006mg/kg。分别记录麻醉前和麻醉30、60、90min及术毕血气指标变化;分别于各时间点采血监测患者血管内皮生长因子(VEGF)和血管性假血友病因子(von willebrand factor,vWF)的变化;观察平均气道压(PeaK)。结果治疗组术中、术毕各时间点动脉血氧分压(PaO2)均高于对照组(P<0.01);而对照组各时间点PaCO2、PeaK明显增高,差异有统计学意义。盐酸戊乙奎醚组患者手术期间VEGF和vWF水平均低于东莨菪碱组。结论长托宁可以减少合并COPD患者腹部手术时的肺损伤。

Clinical study on penehyclidine for pulmonary endothelial protection in patients with chronic obstructive airway disease undergoing abdominal operation

Objective To study the effect of penehyclidine in the patients with chronic obstructive airway disease undergoing abdominal operation,in order to explore whether penehyclidine can improve lung function.Methods Sixty patients with chronic obstructive airway disease undergoing abdominal operation were divided into Penehyclidine group and control group.Penehyclidine group at preanesthesia,intravenous penehyclidine 0.03mg/kg;Control group preoperative 30min intramuscular scopolamine 0.006mg/kg.Recorded separately preanesthesia,anesthesia and surgery 30,60,90min and oxygenation indexes of blood gas changes;observed mean airway pressure(PeaK).Blood sample were withdrawn at each time-point for detecting the levels of vascular endothelial growth factors(VEGF) and von Willebrand factor(vWF).Results Penehyclidine group at surgery,surgical end of each time point of the arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2) were higher than those in control group(P<0.05);and control group at different time points of the mean airway pressure(PeaK)significantly increased,between the two groups there was significant difference(P<0.05),but the levels of VEGF and vWF of control group were significantly higher than those in the Penehyclidine group(P﹤0.05).Conclusion Penehyclidine can reduce the lung injury in the patients with chronic obstructive airway disease undergoing abdominal operation