丙泊酚与七氟烷对单肺通气状态下胸科手术患者炎症因子和肺功能影响的对比分析

目的 对比丙泊酚与七氟烷对于单肺通气胸科手术患者炎症因子和肺功能影响,为麻醉选择提供参考。 方法 选取2014年6月-2018年6月金华市中医医院普胸外科收治的264例胸科手术患者,按照随机数字表法分为2组,A组在麻醉中使用丙泊酚(130例),B组使用七氟烷(134例)。实施单肺通气(one lung ventilation,OLV),检测麻醉诱导前5 min(T0)、OLV后即刻(T1)、OLV后45 min(T2)、OLV后90 min(T3)、手术结束后(T4)的血浆IL-1浓度、NF-κB DNA结合活性、肺泡-动脉血氧分压差(P_A-aO₂)、RI和OI。 结果 在T2、T3、T4时刻,A、B 2组IL-1和NF-κB DNA结合活性均较T0、T1时刻升高(均P<0.05),且A组T2、T3、T4时刻的IL-1和NF-κB DNA结合活性均分别低于B组相对应时刻的检测值(均P<0.05);在T2、T3、T4时刻,A、B两组P_A-aO₂和RI均较T0、T1时刻升高(均P<0.05),且A组T2、T3、T4时刻的P_A-aO₂和RI均分别高于B组相对应时刻的P_A-aO₂和RI(均P<0.05);在T2、T3、T4时刻,A、B两组OI均较T0、T1时刻下降(均P<0.05),且A组T2、T3、T4时刻的OI均分别高于B组相对应时刻的OI(均P<0.05)。 结论 对于单肺通气的胸科手术患者,全醉中使用丙泊酚较七氟烷引发的肺损伤炎症反应更轻,对肺功能影响更小。 

Comparative analysis of effects of propofol and sevoflurane on inflammatory factors and pulmonary function in patients undergoing thoracic surgery with one lung ventilation

Objective To compare the effects of propofol and sevoflurane on inflammatory factors and pulmonary function in patients undergoing thoracic surgery with one lung ventilation,and to provide a reference for the choice of clinical anesthesia. Methods Total 264 patients with thoracic surgery admitted to our hospital were enrolled, who were divided into group A used propofol in anesthesia (130 cases), group B used sevoflurane (134 cases) according to the random number table rule.All patients underwent One Lung Ventilation (OLV) during general anesthesia.Interleukin-1 (IL-1), nuclear factor-κB (NF-κB) DNA binding activity,alveolar-arterial oxygen partial pressure difference (P_A-aO₂),respiratory index (RI), and oxygenation index (OI) were measured at 5 min before induction (T0), immediately after OLV (T1), 45 min after OLV (T2), 90 min after OLV (T3), and after surgery (T4). Results At the time of T2, T3 and T4, the IL-1 and NF-κB DNA binding activities of the two groups were higher than those of T0 and T1 (all P<0.05), and the IL-1 and NF-κB DNA binding activities in group A at T2, T3 and T4 were lower than those in group B (all P<0.05). At the time of T2, T3 and T4, both P_A-aO₂ and RI of the two groups were higher than those of T0 and T1 (all P<0.05), and P_A-aO₂ and RI of group A at T2, T3 and T4 were higher than those of group B (all P<0.05). At the time of T2, T3 and T4, the OI of the two groups decreased compared with T0 and T1 (all P<0.05), and the OI of group A at T2, T3 and T4 was higher than thoseof group B (all P<0.05). Conclusion For patients undergoing thoracic surgery with one lung ventilation, the use of propofol in anesthesia has less inflammatory response induced by lung injury,and has less effect on lung function.